{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:15:42Z","timestamp":1788257742907,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To define a sweet zone of repair tension that maximizes tendon\u2010to\u2010bone healing while maintaining early functional safety in a rat model of rotator cuff repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty\u2010eight rats were used to create a graded\u2010tension supraspinatus repair model with four discrete repair tensions: minimal\u2010tension (MinT), low\u2010tension (LowT), medium\u2010tension (MedT), and high\u2010tension (HiT) at two postoperative time points (n\u2009=\u20096 per group per time point). Intraoperative peak tension was measured during supraspinatus tendon reattachment using a digital tension gauge and normalized to tendon cross\u2010sectional area (N\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ). Functional recovery was assessed by gait analysis at 2 and 4\u2009weeks; magnetic resonance imaging evaluated edema and tendon continuity; biomechanical testing quantified failure load, stiffness, and stress; histology assessed enthesis organization, fibrocartilage formation, and collagen fiber alignment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Measured repair stresses were 0.015, 0.060, 0.110, and 0.305\u2009N\/mm\n                      <jats:sup>2<\/jats:sup>\n                      for MinT, LowT, MedT, and HiT groups, respectively. At 4\u2009weeks, MedT showed superior biomechanical healing, achieving the highest LowT ultimate failure load (23.24\u2009\u00b1\u20092.08\u2009N) versus MinT (14.78\u2009\u00b1\u20091.40\u2009N,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.001) and HiT (14.90\u2009\u00b1\u20090.94\u2009N,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and the greatest stiffness (11.63\u2009\u00b1\u20090.46\u2009N\/mm) versus LowT (8.44\u2009\u00b1\u20090.13\u2009N\/mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), MinT (6.35\u2009\u00b1\u20091.36\u2009N\/mm,\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u2009.003), and HiT (3.05\u2009\u00b1\u20090.04\u2009N\/mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Histologic healing was also best in MedT and worst in HiT (MedT 14.00\u2009\u00b1\u20091.10 vs. MinT 10.17\u2009\u00b1\u20090.75, LowT 11.17\u2009\u00b1\u20090.98, and HiT 8.83\u2009\u00b1\u20090.75; overall\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Overall, outcomes followed a bell\u2010shaped relationship with repair stress, defining a sweet zone centered at 0.10 to 0.12\u2009N\/mm\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study identifies a sweet zone of repair tension (0.10\u20100.12\u2009N\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ) that maintains early functional safety and achieves superior late structural and mechanical outcomes compared with under\u2010 or over\u2010tensioned repairs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Rotator cuff repairs should aim not only to avoid excessive tension but also to target the sweet zone to optimize enthesis regeneration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70471","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:40:17Z","timestamp":1788255617000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Repair\u2010Tension Sweet Zone Maximizes Tendon\u2010to\u2010Bone Healing in a Rat Rotator Cuff Model"],"prefix":"10.1002","author":[{"given":"Qiaonan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. 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