PURPOSE: Arthroscopic rotator cuff repair has evolved, with suture anchor-based techniques like single-row (SR) and Double-row Suture-bridge (DRSB) gaining popularity. Despite improvements, early repair failures remain concerning, necessitating continued assessment of repair methods and devices' lasting impact. This study compares DRSB versus SR repairs at 24 months minimum follow-up, hypothesizing superior clinical outcomes and improved tendon healing with DRSB techniques. METHODS: Fifty patients with rotator cuff tears underwent either SR or DRSB repairs. Clinical evaluation included standardized scoring systems and strength testing. Magnetic Resonance Imaging (MRI) assessed tendon integrity. Partial cuff tears were evaluated according to Snyder's Southern California Orthopaedic Institute rotator cuff classification system, which classifies <
2 cm lesions as C2 in its scoring system. RESULTS: Both groups showed comparable clinical outcomes, strength and MRI findings at 24 months minimum follow-up. No significant correlation was found between repair technique and clinical outcomes or retear rates. Preoperative Patte and Goutallier grades >
1 were associated with lower postoperative Constant-Murley scores. CONCLUSION: This study suggests that both SR and DRSB techniques offer comparable clinical outcomes and tendon healing rates for rotator cuff tears in patients over 55 at 24 months minimum follow-up. While limitations exist, our findings contribute to understanding optimal surgical approaches, emphasizing individualized treatment based on patient characteristics and surgeon expertise. Further research, including randomized controlled trials with long-term follow-up, is needed to refine treatment algorithms and improve patient outcomes in rotator cuff surgery. LEVEL OF EVIDENCE: Level III.