{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:27Z","timestamp":1789844547643,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:00:00Z","timestamp":1749945600000},"content-version":"vor","delay-in-days":75,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Repair techniques for posterior meniscal root (PMMR) tears include repair with transtibial pull\u2010out and anchors. An alternative approach uses all\u2010suture anchors pulled in, avoiding a posterior medial portal. While clinical feasibility has been assessed, biomechanical properties of this technique remain unknown. We hypothesised that the biomechanical properties using the pull\u2010in technique would be comparable to those achieved with conventional repair techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty fresh\u2010frozen porcine tibiae were fixed in a steel pot. Whereas in group (1) the native meniscal root was kept intact (native meniscal root (NM)), the PMMR was sectioned and refixed in groups (2)\u2013(5): (2) Double\u2010loaded suture anchor (screw anchor) (SA), (3) transtibial pull\u2010out repair with two sutures (TTPO), (4) double\u2010loaded pull\u2010in repair with all\u2010suture anchor that was pulled into the subcortical bone which was predrilled from retrograde direction (PULL) and (5) double\u2010loaded push\u2010in repair with all\u2010suture anchor traditionally pushed into the predrilled subcortical bone in antegrade direction (PUSH). Testing was performed using a universal testing machine with 1000 cycles (5\u201320\u2009N\/0.5\u2009Hz) with subsequent load\u2010to\u2010failure (LTF) meaning failure of the NM or refixation. Outcomes measured included LTF (N), cyclic displacement (mm), and stiffness (N\/mm). The failure mode was documented macroscopically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No repair technique restored the stability of the NM, reaching 1064.6\u2009\u00b1\u2009226.0\u2009N in LTF (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001). Reconstructions had significantly lower LTF: SA (251.4\u2009\u00b1\u200952.8\u2009N), TTPO (233.4\u2009\u00b1\u200950.0\u2009N), PULL (206.2\u2009\u00b1\u200986.5\u2009N) and PUSH (214.3\u2009\u00b1\u200955.2\u2009N). The NM showed the highest stiffness with 156.1\u2009\u00b1\u200976.3\u2009N\/mm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u2009.0001) compared to (SA) 36.2\u2009\u00b1\u200910.1\u2009N\/mm, (TTPO) 33.6\u2009\u00b1\u20096.2\u2009N\/mm, (PULL) 36.8\u2009\u00b1\u200912.7\u2009N\/mm, (PUSH) 27.7\u2009\u00b1\u20096.6\u2009N\/mm. Increased displacement after 1000 cycles was shown, with (2.3\u2009\u00b1\u20090.7\u2009mm) in PULL, only with significant differences noted between NM (1.5\u2009\u00b1\u20090.8\u2009mm) and PUSH (3.1\u2009\u00b1\u20090.7\u2009mm) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u2009.001), NM and SA (2.5\u2009\u00b1\u20090.8\u2009mm) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u2009.05), and TTPO (2.1\u2009\u00b1\u20090.7\u2009mm) and PUSH (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u2009.05). No failures occurred during cyclic loading. Failure after LTF was always a suture cut\u2010out at the meniscus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current repair techniques for posterior medial root tears do not fully restore the biomechanical properties of an intact root. The new pull\u2010in technique with an all\u2010suture anchor which is pulled in instead of pushed in shows biomechanical properties comparable to conventional methods, especially regarding LTF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>There is no level of evidence as this study was an experimental laboratory study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70310","type":"journal-article","created":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T15:17:57Z","timestamp":1750000677000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A novel meniscal root refixation pull\u2010in technique with an all\u2010suture anchor shows biomechanical properties comparable to standard suture anchor and transtibial pull\u2010out techniques"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3220-285X","authenticated-orcid":false,"given":"Thorben","family":"Briese","sequence":"first","affiliation":[{"name":"Department of Trauma, Hand\u2010 and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaris","family":"Kieninger","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand\u2010 and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Peez","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand\u2010 and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Deichsel","sequence":"additional","affiliation":[{"name":"Department of 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