One common cause of shoulder pain that frequently leads to function loss & a lower quality of life is rotator cuff tears. When conservative therapies are insufficient to relieve the condition, surgery is recommended [1]. The gold standard of care is arthroscopic rotator cuff repair (ARCR), which has benefits over open surgery such as less tissue damage & quicker recovery. Due to its ease of use, reduced risk of complications, & potential to produce results that are on par with more complicated methods like double-row restorations, the single-row repair approach has grown in popularity [2].

Although non-surgical treatment may be the first option, research indicates that surgical repair produces better results. According to Van Der Meijden et al., individuals who have an unbroken rotator cuff after surgery have much better functional outcomes than those who have re-tears [3]. According to Davey et al., arthroscopic rotator cuff repair (ARCR) has surpassed open repair as the preferred surgical approach because of its benefits, which include less pain following surgery, a shorter hospital stay, faster rehabilitation, & better cosmetic outcomes [4].

There have been reports of complications, including knot impingement, tendon suture cutting, early device loosening, anchor-related cyst formation, & revision surgery-related problems.10-13 As a result, surgeons are increasingly using specialized arthroscopic implantation devices for TO repair.

Assessing the functional results of patients who had single-row arthroscopic rotator cuff surgery is the goal of this study [5–6]. This study will shed light on the efficacy of single-row repair for rotator cuff injuries by emphasizing pain management, functional enhancement, & total shoulder rehabilitation.

This was a retrospective cohort study conducted at LN Medical College Bhopal. We included 30 patients who underwent single-row arthroscopic rotator cuff repair. The inclusion criteria were:

• Age between 40 & 70 years
• Diagnosis of full-thickness rotator cuff tear (supraspinatus or infraspinatus)
• Failure of conservative treatment for at least 3 months
• No significant shoulder comorbidities (e.g., severe osteoarthritis, labral tears)

Exclusion criteria included:

• Partial-thickness rotator cuff tears
• Prior shoulder surgery
• Acute traumatic tears
• Systemic conditions affecting healing

Surgical Technique

The surgeries were performed by a single experienced surgeon using standard arthroscopic techniques. A single-row repair technique was employed, where the rotator cuff tendon was reattached to the humeral head using a series of suture anchors. Postoperatively, the rehabilitation protocol involved passive range-of-motion exercises starting at 1-2 weeks, progressing to active exercises at 6 weeks, & full activity after 6 months.

Outcome Measures

Functional outcomes were assessed using the following tools:

1. Constant-Murley Score (CMS): This composite score evaluates pain, shoulder strength, range of motion, & activities of daily living. The total score ranges from 0 to 100, with higher scores indicating better function.
2. Visual Analog Scale (VAS) for Pain: Pain intensity was assessed on a scale from 0 (no pain) to 10 (worst pain imaginable).
3. American Shoulder & Elbow Surgeons (ASES) Score: This score includes subjective assessments of shoulder pain & functional ability, with scores ranging from 0 to 100.

Patients were evaluated preoperatively, at 6 months, & at 1 year post-surgery

Demographic & Preoperative Data

Table 1: Patient Demographics

Functional Outcomes at Preoperative, 6-Month, & 1-Year Follow-Up

Table 2: Functional Scores

There was a statistically significant improvement in all functional scores between preoperative & follow-up assessments (p < 0.05).

Complications

Table 3: Complications

The re-tear rate was 6.7% (02 patients), & 3.3% (01 patient) experienced delayed healing due to non-compliance with rehabilitation. The chi-square statistic is 0.1389. The p-value is .709388. The result is not significant at p < .05.

Additional Observations

• There was no significant difference in outcomes based on tear size or patient gender.
• All patients showed improvement in shoulder range of motion & strength.

No serious adverse events such as infection, nerve damage, or need for reoperation occurred

Studies show that at six months & a year after surgery, single-row arthroscopic rotator cuff restoration significantly improves functional outcomes & pain alleviation [7]. Strength, range of motion, & everyday function all increased, as seen by the significant improvement in the Constant-Murley score, which gauges overall shoulder function. In a similar vein, postoperative shoulder functionality improved & pain was significantly reduced, according to the ASES & VAS levels.

These results are in line with earlier research that demonstrated the single-row approach had positive results. These favorable outcomes are probably a result of the single-row technique's ease of use & low level of invasiveness. The low prevalence of complications, especially the lack of infection & nerve damage, further supports the single-row approach's safety [8–9].

It is crucial to remember that, despite the 6.7% re-tear rate, this is similar to prior research on arthroscopic rotator cuff repair. The very brief follow-up time & the retrospective methodology of this study are among its drawbacks. To evaluate the repair's longevity & the likelihood of re-tearing over time, longer-term research would be helpful.

Traditional transosseous procedures were displaced by arthroscopic fixation with anchors, which became the new gold standard among less experienced surgeons & reduced them to a secondary role [10]. Nevertheless, there has been no proof of superiority over the open transosseous repair method, even with the development of ever-better devices. Authors like Hasler et al. have expressed interest in this topic. In a randomized controlled study involving 40 patients, they compared arthroscopic repair with open repair & found that the two procedures had comparable clinical & radiological outcomes at a 2-year follow-up, with a high satisfaction rate,                     a comparable complication rate, & an overall re-rupture rate of 30% [11].

In his randomized controlled trial, Randelli found that the transosseous fixation approach reduced pain rates in the initial postoperative period [12]. Since the records were taken in the late postoperative phase, these results could not be verified in this sample.

Single-row arthroscopic rotator cuff repair is an effective surgical technique that significantly improves functional outcomes & reduces pain in patients with full-thickness rotator cuff tears. With a low complication rate & satisfactory patient outcomes, this technique is a viable option for patients seeking treatment for rotator cuff injuries.

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