{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T12:07:38Z","timestamp":1785154058404,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"\n Purpose<\/jats:title>\n To compare the biomechanical performance of 4 common suture configurations, simple suture, horizontal mattress, Krackow, and modified Mason\u2010Allen, in endoscopic repair of proximal hamstring tendon avulsions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Twenty\u2010four cadaveric proximal hamstring tendons were randomized to 1 of the 4 repair groups (simple, horizontal mattress, Krackow, and Mason\u2010Allen; n\u2009=\u20096 each). All constructs underwent uniaxial load\u2010to\u2010failure testing after preconditioning using a mechanical testing system. Primary outcomes included ultimate failure load (N) and linear stiffness (N\/mm). Failure modes were recorded.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ultimate failure load was higher for Krackow (283.1\u2009\u00b1\u200967.9 N; 95% confidence interval [CI], 220.3\u2010345.8) compared with simple suture (141.2\u2009\u00b1\u200944.6 N; 95% CI, 99.9\u2010182.5;\n P<\/jats:italic>\n \u2009=\u2009.002) and for Mason\u2010Allen (282.5\u2009\u00b1\u2009102.8 N; 95% CI, 187.4\u2010377.6) compared with simple suture (\n P<\/jats:italic>\n \u2009=\u2009.013). Horizontal mattress also showed greater failure load than simple suture (239.7\u2009\u00b1\u200968.9 N; 95% CI, 176.0\u2010303.4;\n P<\/jats:italic>\n \u2009=\u2009.018). CIs for Krackow, Mason\u2010Allen, and horizontal mattress overlapped. Linear stiffness did not differ significantly among configurations (all\n P<\/jats:italic>\n \u2009>\u2009.05). The predominant failure mode was suture pull\u2010through at the tendon\u2010suture interface (75% of specimens).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Suture configurations with greater tendon purchase (Krackow, Mason\u2010Allen) provided nearly double the failure load compared with simple sutures. Horizontal mattress sutures also provided comparable strength to locking patterns, highlighting a technically feasible alternative when portal access limits locking configurations in endoscopic repair.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance<\/jats:title>\n These biomechanical findings suggest that locking configurations, when achievable endoscopically, may enhance repair strength and reduce vulnerability to failure. The comparable performance of the horizontal mattress highlights a practical option when traditional locking patterns are not technically feasible. As endoscopic hamstring repair continues to evolve, optimizing suture configuration represents a key opportunity to improve repair robustness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/arj.70437","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:50:12Z","timestamp":1785153012000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Suture Configurations With Greater Tendon Purchase Show Increased Time\u2010Zero Fixation Strength in Endoscopic Proximal Hamstring Repair"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6046-7356","authenticated-orcid":false,"given":"Taylor K.","family":"Calibo","sequence":"first","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2634-9484","authenticated-orcid":false,"given":"Joseph T.","family":"Featherall","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"The Steadman Clinic Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1002-6314","authenticated-orcid":false,"given":"Tyler","family":"Perleberg","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0750-5469","authenticated-orcid":false,"given":"Madeline","family":"Blankenship","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1682-0444","authenticated-orcid":false,"given":"Justin","family":"Hollenbeck","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Zadorozny","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8154-658X","authenticated-orcid":false,"given":"Onur","family":"Hapa","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Godin","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"The Steadman Clinic Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0358-3331","authenticated-orcid":false,"given":"Marc J.","family":"Philippon","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"The Steadman Clinic Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s12178-023-09821-7","article-title":"Proximal hamstring ruptures: Treatment, rehabilitation, and return to play","volume":"16","author":"Looney AM","year":"2023","journal-title":"Curr Rev Musculoskelet Med."},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.arthro.2020.12.201","article-title":"Proximal hamstring tendon injuries: Diagnosis and management","volume":"37","author":"Sheean AJ","year":"2021","journal-title":"Arthroscopy."},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"e703","DOI":"10.5435\/JAAOS-D-24-01162","article-title":"Hamstring injuries in athletes: Anatomy, pathology, and 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