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Participants were 1:1 randomized to undergo ARCR using the double\u2010row suture\u2010bridge technique with BMS (BMS group) or with decortication (DEC group) for footprint preparation. The primary outcome was the American Shoulder and Elbow Surgeons score (range, 0\u2010100, with greater scores indicating better shoulder function and fewer symptoms) at 24 months. Secondary outcomes included patient\u2010reported outcomes, physical examinations, and rotator cuff integrity (evaluated on magnetic resonance imaging using a 5\u2010graded system).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 120 participants (age, 58.7 \u00b1 8.1 years; 83 females [69.2%]) enrolled and randomized between May 2017 and November 2021, 109 (90.8%) were analyzed with the completion of follow\u2010up visits. The American Shoulder and Elbow Surgeons scores at 24 months were not statistically significantly different between the BMS and DEC groups (89.2 \u00b1 12.2 vs 87.8 \u00b1 13.9; adjusted difference, 1.7; 95% confidence interval \u22123.3 to 6.7;\n                      <jats:italic>P<\/jats:italic>\n                      = .498). The BMS group showed superior rotator cuff integrity (incomplete healing, 33.9% vs 54.7%;\n                      <jats:italic>P<\/jats:italic>\n                      = .029) and abduction muscle strength (8.7 \u00b1 3.2 vs 7.4 \u00b1 3.3 kg;\n                      <jats:italic>P<\/jats:italic>\n                      = .031) at 24 months as compared with the DEC group; the superiority was more significant in the subgroup of participants with higher shoulder activity levels. The rates of adverse events were comparable between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among shoulder active patients undergoing ARCR, BMS did not result in superior patient\u2010reported outcomes at 24 months postoperatively compared with decortication. Nevertheless, BMS resulted in greater rates of tendon healing and clinically significant improvement in abduction strength and thus can be recommended in patients requiring high levels of manual labor or sports activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, randomized clinical trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2025.01.038","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T19:13:18Z","timestamp":1738696398000},"page":"2740","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Bone Marrow Stimulation Yielded Similar Clinical Outcomes With Improved Tendon Healing and Abduction Strength Compared With Decortication for Arthroscopic Rotator Cuff Repair in Shoulder Active Patients"],"prefix":"10.1002","volume":"41","author":[{"given":"Zipeng","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Sports Medicine Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang'an","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine 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