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Objectives Bankart lesion is one of the most common lesions of the glenohumeral joint. Several double‐row suture methods were reported for Bankart repair, which could provide more stability, yet more motion limitation and complications. Therefore, we introduced a new double‐row Bankart repair technique, key point double‐row suture which used one anchor in the medial line. The purpose of this article is to investigate the clinical outcomes of this new method and to compare it with single‐row suture. Methods Seventy‐eight patients receiving key point double‐row suture or single‐row suture from October 2010 to June 2014 were collected retrospectively. The basic information including gender, age, dominant arm, and number of episodes of instability was collected. Before surgery, the glenoid bone loss was measured from the CT scan. The visual analogue scale, American shoulder and elbow surgeons, the University of California at Los Angeles shoulder scale, and subjective shoulder value were valued before surgery and at the last follow‐up. Results Forty‐four patients (24 patients receiving single‐row suture and 20 patients receiving key point double‐row suture) were followed up successfully. The follow‐up period was 9.2 ± 1.1 years (range, 7.8–11.4 years). At the last follow‐up, no significant differences were detected for any of the clinical scores. The recurrence rate was 12.5% for the single‐row group and 10% for the double‐row group, respectively (p = 0.795) 14 patients (31.8%) in the single‐row group and nine patients (26.5%) in the double‐row group were tested for active range of motion. A statistically significant difference was found only for the internal rotation at 90° abduction (48.9° for single‐row and 76.7° for key point double‐row, p = 0.033). Conclusion The key point double‐row sutures for Bankart lesions could achieve similar long‐term outcomes compared with single‐row suture, and one medial anchor did not result in a limited range of motion. The low recurrence rate and previous biomechanical results also indicate the key point double‐row suture is a reliable method. The key point double‐row suture technique, as compared to the single‐row suture technique, provides an additional medial anchor without any significant reduction in the range of motion. The biomechanical results and low recurrence rate of the key point double‐row suture technique further support its reliability and effectiveness in Bankart repair.

The Single-Row Facility Layout Problem (SRFLP) is a well-known combinatorial optimization problem. The objective of SRFLP is to find out the arrangement of facilities with given lengths on a line so that the weighted sum of the distances between all pairs of facilities is minimized. This problem is known to be NP-hard. Hence, a population-based improvement heuristic algorithm with local search is presented in this article to solve SRFLP. The proposed algorithm works well also for the Single-Row Equidistant Facility Layout Problem (SREFLP), where the length of each facility is equal. The computational efficiency of the proposed algorithm is checked with the instances of sizes ranging from 5 to 300 available in the literature for SRFLP and SREFLP. The obtained results are compared to those from different state-of-the-art algorithms. The proposed algorithm achieves best known solutions to date for every instance considered in this article in reasonable computational time.

Background: Comparative studies and randomized controlled trials (RCTs) often use the P (probability) value to convey the statistical significance of their findings. P values are an imperfect measure, however, and are vulnerable to a small number of outcome reversals to alter statistical significance. The inclusion of a fragility index (FI) and fragility quotient (FQ) may aid in the interpretation of a study’s statistical strength. Purpose/Hypothesis: The purpose of this study was to examine the statistical stability of studies comparing single-row to double-row rotator cuff repair. It was hypothesized that the findings of these studies would be vulnerable to a small number of outcome event reversals, often fewer than the number of patients lost to follow-up. Study Design: Systematic review; Level of evidence, 3. Methods: We analyzed comparative studies and RCTs on primary single-row versus double-row rotator cuff repair that were published between 2000 and 2021 in 10 leading orthopaedic journals. Statistical significance was defined as a P < .05. The FI for each outcome was determined by the number of event reversals necessary to alter significance. The FQ was calculated by dividing the FI by the respective sample size. Results: Of 4896 studies screened, 22 comparative studies, 10 of which were RCTs, were ultimately included for analysis. A total of 74 outcomes were examined. Overall, the median FI was 2 (interquartile range [IQR], 1-3), and the median FQ was 0.035 (IQR, 0.020-0.057). The mean FI was 2.55 ± 1.29, and the mean FQ was 0.043 ± 0.027. In 64% of outcomes, the FI was less than the number of patients lost to follow-up.) Additionally, 81% of significant outcomes needed just a single outcome reversal to lose their significance. Conclusion: Over half of the studies currently used to guide clinical practice have a number of patients lost to follow-up greater than their FI. The results of these studies should be interpreted within the context of these limitations. Future analyses may benefit from the inclusion of the FI and the FQ in their statistical analyses.

Purpose Influence of the initial rotator cuff tear size and of different subregions of the SSP tendon on the cyclic loading behavior of a modified single-row reconstruction compared to a suture-bridging double-row repair. Methods Artificial tears (25 and 35 mm) were created in the rotator cuff of 24 human cadaver shoulders. The reconstructions were performed as a single-row repair (SR) using a modified suture configuration or a suture-bridge double-row repair (DR). Radiostereometric analysis was used under cyclic loading (50 cycles, 10–180 N, 10–250 N) to calculate cyclic displacement in three different planes (anteroposterior (x), craniocaudal (y) and mediolateral (z) level). Cyclic displacement was recorded, and differences in cyclic displacement of the anterior compared to the posterior subregions of the tendon were calculated. Results In small-to-medium tears (25 mm) and medium-to-large tears (35 mm), significant lower cyclic displacement was seen for the SR-reconstruction compared to the DR-repair at 180 N ( p  ≤ 0.0001; p  = 0.001) and 250 N ( p  = 0.001; p  = 0.007) in the x -level. These results were confirmed in the y -level at 180 N ( p  = 0.001; p  = 0.0022) and 250 N ( p  = 0.005; p  = 0.0018). Comparison of the initial tear sizes demonstrated significant differences in cyclic displacement for the DR technique in the x -level at 180 N ( p  = 0.002) and 250 N ( p  = 0.004). Comparison of the anterior versus the posterior subregion of the tendon revealed significant lower gap formation in the posterior compared to the anterior subregions in the x -level for both tested rotator cuff repairs ( p  ≤ 0.05). Conclusions The tested single-row repair using a modified suture configuration achieved superior results in three-dimensional measurements of cyclic displacement compared to the tested double-row suture-bridge repair. The results were dependent on the initial rupture size of the rotator cuff tear. Furthermore, significant differences were found between tendon subregions of the rotator cuff with significantly higher gap formation for the anterior compared to the posterior subregions.

Background: There is no clinical gold standard for the indications for single-row (SR) versus double-row (DR) repair according to small, large, or massive rotator cuff tear size. Purpose: To conduct a meta-analysis to compare the clinical outcomes and retear rates after arthroscopic SR and DR repair for rotator cuff injuries with different tear sizes. Study Design: Systematic review; Level of evidence, 3. Methods: On the basis of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, the PubMed, Embase, Cochrane Library databases, Web of Science, China National Knowledge Infrastructure, and China BioMedical Literature database were searched for relevant studies published before November 1, 2021, using the following search terms: “Rotator Cuff Injuries,” “Rotator Cuff Tears,” “Arthroscopy,” “Arthroscopic Surgery,” “single-row,” and “double-row”; a total of 489 articles were retrieved. Quality evaluation was conducted for all the studies that met the inclusion criteria. This study evaluated the Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, and range of motion (ROM) as well as retear rate. A fixed-effects or random-effects model was adopted to calculate the results and assess risk. Results: A total of 10 clinical studies were included, with 404 cases of DR and 387 cases of SR. Regarding overall results, DR had better forward elevation ROM (mean difference [MD] = -4.03° [95% CI, -6.00° to -2.06°]; P < .0001; I 2 = 46%) and a lower retear rate (MD = 2.39 [95% CI, 1.40 to 4.08]; P = .001; I 2 = 0%) compared with SR repair. With regard to small tears (<3 cm), there was no noticeable difference on any of the 3 outcome scores between SR and DR. For large rotator cuff tears (≥3 cm), DR repair showed significantly better ASES scores (MD = -3.09 [95% CI, -6.19 to 0.02]; P = .05; I 2 = 73%) and UCLA scores (MD = -1.47 [95% CI, -2.21 to -0.72]; P = .0001; I 2 = 31%) compared with SR repair. Conclusion: Our meta-analysis revealed that DR had better UCLA scores, ASES scores, and ROM in forward elevation and lower retear rates. In rotator cuff tears <3 cm, there were no statistical differences in clinical outcome between SR and DR.

There is substantial evidence indicating that double-row (DR) repair restores more of the anatomic rotator cuff footprint and is biomechanically superior to single-row (SR) repair. Transosseous-equivalent (TOE) techniques have shown biomechanical advantages when compared with traditional DR, including increased contact at the rotator cuff footprint, higher pressure at the tendon-bone interface, and increased failure strength. Several meta-analyses of evidence level 1 and 2 studies have shown a lower rate of failed/incomplete healing when DR repair was compared with SR repair types. There is some limited evidence that TOE techniques improve healing rates in large and massive tears as compared with SR and DR. Overall, most level 1 and 2 studies have failed to prove a significant difference between SR and DR repairs in terms of clinical outcomes. However, most studies include only short-term follow-up, minimizing the impact that the higher rate of retears/failed healing seen with SR repairs can have in the long term. There are no high-quality clinical studies comparing different DR configurations, and there are currently not enough clinical data to determine the functional advantages of various DR technique modifications over one another. Although numerous biomechanical and clinical studies comparing different rotator cuff repair techniques have been published in the past decade, none has achieved universal acceptance. It is essential for the orthopaedic surgeon to know in detail the available literature to be able to apply the most appropriate and cost-effective technique in terms of healing and functional outcomes. This review provides a critical analysis of the comparative biomechanical and clinical studies among SR, DR, and TOE techniques reported in the literature in the past decade.

Sicklepod is one of the most difficult to control weeds in peanut production in the southeastern United States due to its extended emergence pattern and limited effective herbicides for control. Growers rely on preemergence herbicides as the foundation of their weed control programs; however, postemergence herbicides are often needed for season-long weed control. The objectives of this study were to evaluate the effect of planting pattern and herbicide combinations for sicklepod control in peanut crops. Due to rapid canopy closure, twin-row planting improved late-season sicklepod control by 13% and peanut yield by 5% compared with a single-row pattern. A preemergence application of fluridone, flumioxazin, or fluridone + flumioxazin provided 76% to 89% control of sicklepod 28 d after preemergence. Regardless of the herbicide applied preemergence, paraquat + bentazon + S-metolachlor applied early postemergence was required to achieve ≥90% sicklepod control 28 d after early postemergence. All preemergence herbicide treatments followed by (fb) S-metolachlor or diclosulam + S-metolachlor applied early postemergence provided <90% control 28 d after early postemergence. A mid-postemergence application of imazapic + dimethenamid-P + 2,4-DB controlled sicklepod by 67% to 79% prior to peanut harvest, and biomass reduction was unacceptable (<80%), resulting in difficulty in peanut digging. The highest peanut yield was observed when paraquat + bentazon + S-metolachlor was applied early postemergence fb imazapic + dimethenamid-P + 2,4-DB applied mid-postemergence. Based on the results of this study, a herbicide combination of paraquat + bentazon + S-metolachlor is an important early-season tool for controlling sicklepod in peanut crops. The results also showed that a twin-row planting pattern improved late-season sicklepod control but did not reduce herbicide input to protect peanut yield. Nomenclature: Bentazon; diclosulam; dimethenamid-P; fluridone; flumioxazin; imazapic; paraquat; S-metolachlor; 2,4-DB; sickelpod; Senna obtusifolia L.; peanut; Arachis hypogaea L.

Introduction The aim of this study was to compare the results of single versus double row (TEO) in massive tears of the posterosuperior rotator cuff in patients older than 70 years old. Methods Between October 2019 and July 2022, 46 patients, older than 70 years old, were operated on, in two centers, by one surgeon (FM), in one center, we performed a single-row repair, while in the other a double row, transosseous equivalent. Patients were paired by age and gender. All patients were studied with a preoperative MRI along with preoperative age and gender adjusted constant score. Postoperative patients were evaluated at the end of the FU. Mean time of FU for single row was 3.2 years (2–4.1) and for TOE was 3.5 years (2.4–3). Mean age for SR patients was 71.15 years (70–82) and for TOE was 74.8 years (70–81). We were able to evaluate 20 pairs of patients (15 pairs of females and five pairs of males). Results CS differed in both groups of patients. Patients operated on with TOE had a better, but non-significant CS 81.3 (TOE) versus 75.7 (SR) p  > 0.05. The patients operated own with TOE showed statistically significant better arm abduction strength than patients operated on with SR ( p  < 0.05). There was a trend for patients operated on with TOE to have a better ROM and less pain. Discussion The results of our work show that patients older than 70 years old, with repairable RCT operated on with a transosseous equivalent, have a trend to have a better CS and a significantly better strength than patients operated on with SR.

In this study, for the first time, the classical single row facility layout problem is extended to its dynamic type by considering several planning periods. This new problem consists of two types of costs e.g. material handling cost and rearrangement cost of the departments at the beginning of each period. The problem is formulated by a mixed integer linear programming model. Because of the high complexity of the problem, two well-known meta-heuristic algorithms e.g. the GA and the SA are proposed to solve the problem. In addition, both of the algorithms are hybridized considering the restart and acceptance probability strategies. In order to study the performance of the proposed algorithms, 20 benchmark problems are generated randomly. Considering one of the generated benchmarks, the parameters of the algorithms are tuned by a typical method and final experiments are performed accordingly. The obtained results strongly prove the superiority of the SA hybridized by the restart strategy as it shows much better performance comparing to other proposed algorithms in more than 60% of the benchmarks.

Background: Approximately 6% of people will report Achilles tendon pain during their lifetime, and one-third of these individuals will have Achilles insertional tendinopathy (AIT). For patients who have failed conservative treatment, surgical repair is performed. Achilles tendon repair can occur through various techniques, including a single-row or double-row repair. Purpose: To determine if there are significant advantages to double-row repair over single-row repair with respect to biomechanical and clinical outcomes. Study design: Systematic review; Level of evidence, 3. Methods: A systematic review of the literature was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An electronic search of the EMBASE and PubMed databases was performed for all studies related to surgical treatment of AIT, which yielded 1431 unique results. These included both biomechanical and clinical studies. Clinical studies in which patients were not diagnosed with AIT, underwent surgery for repair of acute Achilles tendon rupture, or studies that included additional procedures such as a concomitant flexor hallucis longus transfer were excluded. Eligible studies were independently screened by 2 reviewers. A risk-of-bias assessment was conducted using the Cochrane Risk Of Bias In Non-randomized Studies–of Interventions and risk-of-bias tool for randomized trials tools. Results: A total of 23 studies were included, 4 of which were biomechanical studies and 19 were clinical studies. Biomechanical comparison found that there was a significant advantage to using double-row versus single-row fixation with respect to load at yield (354.7 N vs 198.7 N; P = .01) and mean peak load (433.9 N vs 212 N; P = .042). There was no significant difference between double-row and single-row repair with respect to load to failure. Significant heterogeneity of the studies did not allow for a statistical comparison of the clinical outcomes between double-row and single-row repairs. Conclusion: Although biomechanical studies favor double-row repair for AIT, the current data available on the clinical outcomes are not sufficient to determine if there is a clinical advantage of double-row repair. Larger, prospective randomized controlled trials utilizing validated outcome measures are needed to further elucidate whether the biomechanical advantages associated with double-row repair also translate into improved patient-reported outcomes.