Transosseous repair technique as effective as single row anchor repair for rotator cuff tear: study

Transosseous repair (TO) has declined in popularity since the introduction of suture anchors and arthroscopic methods in 1985. Nevertheless, failure rates remain significant, at 12% to 40% and the cost of these devices is considerable. Consequently, interest has revived in arthroscopic transosseous technique, Julio Solis Kronthal et al conducted a study to evaluate whether anchorless transosseous arthroscopic fixation achieves similar or better functional outcomes than single-row fixation with anchors in patients with rotator cuff tears.

60 shoulders with complete rotator cuff tears were evaluated, divided into two groups based on fixation technique: Group 1 (transosseous) and Group 2 (single row with anchors). All patients had a minimum 12-month follow-up, including clinical assessments (VAS, range of motion) and functional questionnaires (ASES, Constant scores). The study has been published in ‘International Journal of Research in Orthopaedics’

Key findings of the study were:

• No significant differences were found in VAS scores at 6 months (t=0.244, p=0.404) and 12 months (t=0.220, p=0.413).

• There was no superiority of either group in motion ranges at 12 months (forward flexion t=0.732, p=0.234; external rotation t=1.608, p=0.057; abduction t=0.583, p=0.281).

• Both groups reported high postoperative satisfaction, with no differences in ASES (t=0.153, p=0.439) and constant scores (t=0.572, p=0.285) at 12 months.

“In conclusion, this study demonstrates that, when evaluating functional outcomes, pain and range of motion at 12 months postoperatively, the transosseous repair technique is comparable in effectiveness to the single-row anchor repair for rotator cuff repair. These findings advocate for the routine implementation of the transosseous technique, particularly in patients with limited access to healthcare resources. However, further comparative studies with extended follow-up periods and larger sample sizes are warranted. Additionally, a cost-effectiveness analysis is essential to assess the economic viability and benefit-to-cost ratio of both therapeutic approaches” the authors commented.

Further reading:

Functional outcomes of arthroscopic rotator cuff repair: transosseous technique versus single-row with anchors, Julio Solis Kronthal et al Int J Res Orthop. 2025 May;11(3):491-497.