Background: There has been no report to date regarding retraction patterns of delaminated rotator cuff tears. The\npurpose of this study was to evaluate the incidence and tearing patterns of delamination and repair integrity after\nthe dual-layer repair of delaminated cuff tears.\nMethods/design: A consecutive series of 64 patients with posterosuperior rotator cuff tears underwent\narthroscopic rotator cuff repair from August 2011 to September 2012. Among the patients, 53 who received either\ndual-layer double-row (DLDR) repair or dual-layer suture bridge (DLSB) repair and 11 who received a single-layer\nrepair were evaluated. The mean follow-up period after surgery was 26.5 months. The retraction direction of the\ndeep and superficial layers was analyzed, and the integrity of the repaired constructs was determined in 37 patients\nthrough magnetic resonance imaging at a mean of 12.1 months after surgery.\nResults: The incidence of delamination was 82.8 %. Posteromedial retraction of the deep and superficial layers was\nobserved in 98.1 and 88.5 % of cases, respectively. The Constant score and UCLA score increased preoperatively to\npostoperatively, showing no significant differences between the dual-layer repair group and single-layer repair\ngroup. Retear was found in two (7.6 %) patients in the dual-layer repair group and three (27.2 %) patients in the\nsingle-layer repair group (p = 0.016).\nConclusions: Differential rotator cuff repair strategies are needed to address rotator cuff tears, since recent studies\nhave changed our concept of rotator cuff tears. We have focused on three areas: incidence, retraction patterns, and\nclinical outcomes. The incidence of delamination was extremely high. Both the superficial layer and deep layer were\nmainly retracted posteromedially. The retraction of the deep layer and superficial layer may be affected by the\ninfraspinatus. Dual-layer rotator cuff repair based on the retraction pattern of delamination is recommended for\nimprovement of repair integrity and of clinical outcomes.
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