{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:52:04Z","timestamp":1790135524148,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"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, Sports Medicine, and Rehabil."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the influence of anchor density on tendon footprint contact mechanics in knotless all\u2010suture anchor compression bridge constructs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Unicortical polyurethane solid foam blocks with a cancellous density of 20\u2009lb\/ft\n                      <jats:sup>3<\/jats:sup>\n                      and a cortical density of 40\u2009lb\/ft\n                      <jats:sup>3<\/jats:sup>\n                      simulated bone. Tendons were replicated with 4.76\u2010mm\u2010thick 40A durometer polyurethane rubber sized to 27\u2009\u00d7\u200912\u2009mm. Test groups consisted of two 2.6\u2010mm all\u2010suture anchor single\u2010row knotless compression bridge constructs evaluated at interanchor distances of 10, 15, 20, and 25\u2009mm. A 3\u2010anchor construct was also evaluated for the 25\u2010mm (large tear) condition. The repair sutures of each construct were individually hooked onto a zeroed, handheld force gauge and manually tensioned to create a minor (&lt;5\u2009N) compressive preload through the tendon. Constructs were incrementally tensioned by +25\u2009N on each suture until failure. Contact area (mm\n                      <jats:sup>2<\/jats:sup>\n                      ), compressive force (N), and contact pressure (kPa) were recorded from the loaded sensing elements in the bridge region.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 25\u2010mm, 3\u2010anchor construct resulted in significantly greater compressive force than any of the 2\u2010anchor groups (107\u2009\u00b1\u20099\u2009N,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Adding a third anchor to the 25\u2010mm bridge resulted in 37% more compressive force when compared with its 2\u2010anchor equivalent. Contact area increased linearly with increasing bridge length. The largest contact area measured at 195\u2009\u00b1\u200911\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      , observed in the 25\u2010mm bridge distance with both the 2\u2010 and 3\u2010anchor constructs. The largest contact pressure was achieved in the 10\u2009mm group (1020\u2009\u00b1\u200958\u2009kPa). Contact pressure significantly decreased with increasing bridge distance and was restored with the addition of a third anchor (683\u2009\u00b1\u200996\u2009kPa) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An inverse relation was identified wherein increasing knotless suture bridge length decreased tendon footprint contact pressure in single\u2010row repairs. The addition of an in\u2010line third anchor in a simulated large\u2010tear model (25\u2009mm) improved contact pressure and compressive force.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>The addition of a third knotless all\u2010suture anchor to large single\u2010row suture bridge repairs shows a noticeable improvement in tendon footprint restoration at time zero.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ars2.70082","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:02:00Z","timestamp":1788746520000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Three\u2010Anchor Knotless Compression Bridges Improve Contact Mechanics in a Biomechanical Model of Large, Single\u2010Row Tendon Repairs"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4873-6389","authenticated-orcid":false,"given":"Nisha M.","family":"Kotta","sequence":"first","affiliation":[{"name":"Department of Research Arthrex Inc.  Naples Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8202-1141","authenticated-orcid":false,"given":"Benjamin L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Research Arthrex Inc.  Naples Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2164-5583","authenticated-orcid":false,"given":"Roger","family":"Quesada\u2010Jimenez","sequence":"additional","affiliation":[{"name":"American Hip Institute Research Foundation  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7418-5605","authenticated-orcid":false,"given":"Anthony N.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Department of Research Arthrex Inc.  Naples Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3937-8647","authenticated-orcid":false,"given":"Benjamin G.","family":"Domb","sequence":"additional","affiliation":[{"name":"American Hip Institute Research Foundation  Chicago Illinois U.S.A."},{"name":"American Hip Institute  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnv035"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520952766"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1120700020922522"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2023.11.019"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2012.11.005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120929330"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241311593"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.03.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.146"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510388152"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00650"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519888182"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-20-01224"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-024-09896-w"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2023.01.007"},{"key":"e_1_2_8_17_1","first-page":"13","volume-title":"Book of standards Volume 13.02","year":"2024"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.07.022"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.engfracmech.2006.10.015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2012.09.033"},{"key":"e_1_2_8_21_1","article-title":"Use of Tekscan pressure sensors for measuring contact pressures in the human knee joint","volume":"6","author":"Herregodts S","year":"2015","journal-title":"Int J Sustain Constr Des."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211015419"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231204314"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509350081"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221135604"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-018-2306-8"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515590596"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520930425"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0941-7"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.09.006"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2022.05.012"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505278256"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.07.002"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2017.05.004"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520919120"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211029029"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.11.019"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015640"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517728718"}],"container-title":["Arthroscopy, Sports Medicine, and Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ars2.70082","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ars2.70082","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ars2.70082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:02:02Z","timestamp":1788746522000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ars2.70082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,6]]},"references-count":38,"alternative-id":["10.1002\/ars2.70082"],"URL":"https:\/\/doi.org\/10.1002\/ars2.70082","archive":["Portico"],"relation":{},"ISSN":["2666-061X","2666-061X"],"issn-type":[{"value":"2666-061X","type":"print"},{"value":"2666-061X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,6]]},"assertion":[{"value":"2025-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70082"}}