Abstract：
UNASSIGNED: The clinical implications of structural integrity have been a subject of long debate. The oversimplified binary categorization of structural integrity into either healing or retear, along with faulty preoperative baselines for comparison, may contribute to the controversy.
UNASSIGNED: To determine how the quality of structural integrity in a repaired cuff tendon affects both clinical and structural outcomes by dividing the patients into groups based on integrity and using the immediate postoperative baseline (time zero).
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A total of 504 patients with a full-thickness rotator cuff tear who underwent arthroscopic rotator cuff repair and were followed up for at least a year with magnetic resonance imaging (MRI) were included. The quality of structural integrity was graded using the Sugaya classification. To evaluate clinical outcomes, pain, range of motion, strength, functional scores, and overall satisfaction and function were used for within- and between-group analyses at the last follow-up. For the assessment of structural outcomes, the Goutallier classification for fatty infiltration (FI) and the tangent sign, occupation ratio, and normalized cross-sectional area for muscle atrophy (MA) were used. The baselines for these structural measurements were both the preoperative and the time-zero MRI scans.
UNASSIGNED: The mean clinical follow-up period was 31.8 ± 27.5 months, and the MRI follow-up period was 10.9 ± 5.3 months. There were 178 (35.3%), 228 (45.2%), 58 (11.5%), 14 (2.8%), and 26 (5.2%) shoulders with Sugaya grades 1, 2, 3, 4, and 5, respectively. Regardless of structural integrity, all clinical outcomes at a mean follow-up of 31.8 months after repair significantly improved compared with those before repair. Only in shoulders with Sugaya grade 1 did the FI of the supraspinatus muscle improve significantly from baseline. FI of the infraspinatus muscle did not change significantly in those with grades 1 and 2 but worsened in those with grades 3 and 5. MA measured using the occupation ratio improved significantly in shoulders with Sugaya grades 1 and 2 but declined in those with grade 5.
UNASSIGNED: This study established a correlation between improved structural integrity of the repaired cuff tendon and enhanced structural outcomes in rotator cuff muscles. Furthermore, the findings revealed that both FI and MA could be reversed in patients exhibiting high-quality structural integrity. However, these structural improvements were not mirrored in the clinical outcomes.
UNASSIGNED: To determine how the quality of structural integrity in a repaired cuff tendon affects both clinical and structural outcomes by dividing the patients into groups based on integrity and using the immediate postoperative baseline (time zero).
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A total of 504 patients with a full-thickness rotator cuff tear who underwent arthroscopic rotator cuff repair and were followed up for at least a year with magnetic resonance imaging (MRI) were included. The quality of structural integrity was graded using the Sugaya classification. To evaluate clinical outcomes, pain, range of motion, strength, functional scores, and overall satisfaction and function were used for within- and between-group analyses at the last follow-up. For the assessment of structural outcomes, the Goutallier classification for fatty infiltration (FI) and the tangent sign, occupation ratio, and normalized cross-sectional area for muscle atrophy (MA) were used. The baselines for these structural measurements were both the preoperative and the time-zero MRI scans.
UNASSIGNED: The mean clinical follow-up period was 31.8 ± 27.5 months, and the MRI follow-up period was 10.9 ± 5.3 months. There were 178 (35.3%), 228 (45.2%), 58 (11.5%), 14 (2.8%), and 26 (5.2%) shoulders with Sugaya grades 1, 2, 3, 4, and 5, respectively. Regardless of structural integrity, all clinical outcomes at a mean follow-up of 31.8 months after repair significantly improved compared with those before repair. Only in shoulders with Sugaya grade 1 did the FI of the supraspinatus muscle improve significantly from baseline. FI of the infraspinatus muscle did not change significantly in those with grades 1 and 2 but worsened in those with grades 3 and 5. MA measured using the occupation ratio improved significantly in shoulders with Sugaya grades 1 and 2 but declined in those with grade 5.
UNASSIGNED: This study established a correlation between improved structural integrity of the repaired cuff tendon and enhanced structural outcomes in rotator cuff muscles. Furthermore, the findings revealed that both FI and MA could be reversed in patients exhibiting high-quality structural integrity. However, these structural improvements were not mirrored in the clinical outcomes.
摘要：
■结构完整性的临床意义一直是争论的话题。将结构完整性过度简化的二元分类为愈合或再撕裂，以及错误的术前比较基线，可能会引发争议。
■通过基于完整性并使用术后即刻基线（时间为零）将患者分为几组，来确定经修复的袖带肌腱的结构完整性质量如何影响临床和结构结果。
■队列研究；证据水平，3.
■共纳入了504例全厚度肩袖撕裂患者，他们接受了关节镜下肩袖修复，并接受了至少一年的磁共振成像（MRI）随访。使用Sugaya分类对结构完整性的质量进行分级。为了评估临床结果，疼痛,运动范围,力量,功能分数，在最后一次随访时，将总体满意度和功能用于组内和组间分析。为了评估结构性结果，脂肪浸润(FI)的Goutallier分类和切线符号，职业比率,使用肌肉萎缩的标准化横截面积（MA）。这些结构测量的基线是术前和零时间MRI扫描。
■平均临床随访时间为31.8±27.5个月，MRI随访时间为10.9±5.3个月。有178人(35.3%)，228（45.2%），58（11.5%），14（2.8%），和26（5.2％）与Sugaya分别为1、2、3、4和5级。不管结构的完整性，与修复前相比,修复后平均随访31.8个月时的所有临床结局均显著改善.仅在Sugaya1级的肩膀中，冈上肌的FI才比基线显着改善。1级和2级的冈下肌的FI没有显着变化，但3级和5级的FI恶化。使用占用率测量的MA在Sugaya1级和2级的肩部中显着提高，但在5级的肩部中下降。
■这项研究建立了修复的袖带肌腱结构完整性改善与肩袖肌肉结构结果增强之间的相关性。此外，研究结果表明,在具有高质量结构完整性的患者中,FI和MA均可逆转.然而,这些结构性改善并未反映在临床结局中.
■通过基于完整性并使用术后即刻基线（时间为零）将患者分为几组，来确定经修复的袖带肌腱的结构完整性质量如何影响临床和结构结果。
■队列研究；证据水平，3.
■共纳入了504例全厚度肩袖撕裂患者，他们接受了关节镜下肩袖修复，并接受了至少一年的磁共振成像（MRI）随访。使用Sugaya分类对结构完整性的质量进行分级。为了评估临床结果，疼痛,运动范围,力量,功能分数，在最后一次随访时，将总体满意度和功能用于组内和组间分析。为了评估结构性结果，脂肪浸润(FI)的Goutallier分类和切线符号，职业比率,使用肌肉萎缩的标准化横截面积（MA）。这些结构测量的基线是术前和零时间MRI扫描。
■平均临床随访时间为31.8±27.5个月，MRI随访时间为10.9±5.3个月。有178人(35.3%)，228（45.2%），58（11.5%），14（2.8%），和26（5.2％）与Sugaya分别为1、2、3、4和5级。不管结构的完整性，与修复前相比,修复后平均随访31.8个月时的所有临床结局均显著改善.仅在Sugaya1级的肩膀中，冈上肌的FI才比基线显着改善。1级和2级的冈下肌的FI没有显着变化，但3级和5级的FI恶化。使用占用率测量的MA在Sugaya1级和2级的肩部中显着提高，但在5级的肩部中下降。
■这项研究建立了修复的袖带肌腱结构完整性改善与肩袖肌肉结构结果增强之间的相关性。此外，研究结果表明,在具有高质量结构完整性的患者中,FI和MA均可逆转.然而,这些结构性改善并未反映在临床结局中.
