title: Serial structural MRI evaluation of arthroscopy rotator cuff repair: does Sugaya's classification correlate with the postoperative clinical outcomes?
abstract: BACKGROUND
  Sugaya's classification is the most commonly used for postoperative evaluation of rotator cuff repairs. However, the correlation between this classification and clinical outcomes after supraspinatus tendon repair were not performed with serial MRI examinations in standardized time intervals.
  
  
  METHODS
  This prospective case series involved 54 patients undergoing repair of the supraspinatus tendon tear. Magnetic resonance imaging (MRI, 1.5 T) was used to determine the Sugaya's classifications at 3, 6, and 12 months, and these data were correlated with the visual analog scale for pain (VAS), Constant and University of California at Los Angeles (UCLA) assessments.
  
  
  RESULTS
  Patients with types I, II, and ≥III of Sugaya's classification experienced pain of 1.27 ± 1.95, 1.00 ± 1.40, and 3.43 ± 3.36, respectively (p = 0.010), according to the VAS. The Constant and UCLA scales did not differ significantly. Type II predominated, though their percentage decreased over time (from 77.8 to 66.7 %), whereas type I became more frequent (from 1.9 to 20.4 %).
  
  
  CONCLUSIONS
  The pain was more intense in patients classified as types III, IV, or V of Sugaya's classification. The postoperative appearance of the supraspinatus tendon was not correlated with the Constant and UCLA scales. The occurrence of type II, the most prevalent, decreased over time, whereas the occurrence of type I increased; these differences were not significant. Level de evidence: prospective cohort evaluation-level III.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Malavolta
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil. drjorgeassuncao@gmail.com.
authors.forename: Jorge Henrique
authors.initials: JH
authors.lastname: Assunção
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Frederico F
authors.initials: FF
authors.lastname: Ramos
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Thiago C
authors.initials: TC
authors.lastname: Ferreira
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Mauro E C
authors.initials: ME
authors.lastname: Gracitelli
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bordalo-Rodrigues
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Arnaldo A
authors.initials: AA
authors.lastname: Ferreira Neto
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D010147:Pain Measurement; D011184:Postoperative Period; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013710:Tendons / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Magnetic resonance imaging; Rotator cuff; Rupture; Shoulder; Structural integrity; Tendons