Review ArticlesRotator Cuff Repair: Single Row Repair Versus Double Row Repair and Superior Capsular ReconstructionSheean, Andrew J. MD*; Hartzler, Robert U. MD, MS†; Burkhart, Stephen S. MD†Author Information *San Antonio Military Medical Center †The San Antonio Orthopaedic Group, Burkhart Research Institute for Orthopaedics (BRIO), San Antonio, TX Disclosure: R.U.H. and S.S.B. are consultants for Arthrex Inc. S.S.B. receives royalties from Arthrex Inc. The remaining author declares no conflict of interest. Reprints: Andrew J. Sheean, MD, San Antonio Military Medical Center, San Antonio, TX (e-mail: firstname.lastname@example.org). Sports Medicine and Arthroscopy Review: December 2018 - Volume 26 - Issue 4 - p 171-175 doi: 10.1097/JSA.0000000000000228 Buy Metrics Abstract The surgical management of rotator cuff (RC) tears has progressed considerably in recent decades. Arthroscopic procedures now represent the mainstay of contemporary treatment approaches. The success of repair is predicated upon the achievement of a secure, durable repair that promotes tendon-to-bone healing. Both single and double row (DR) suture anchor configurations have been described to achieve stable fixation. Although consensus is lacking with regard to the clinical superiority of one configuration over another, trends in the literature suggest that DR repairs may optimize the likelihood of tendon healing and restoration of shoulder strength. In cases of truly irreparable RC tears, superior capsular reconstruction is a promising alternative to open tendon transfer and arthroplasty procedures. The purposes of this concise review are to: (1) explain our preference for a DR repair configuration in almost all circumstances; and (2) advocate superior capsular reconstruction as a viable treatment tactic for truly irreparable RC tears in the absence of significant glenohumeral arthritis. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.