{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T01:12:53Z","timestamp":1784250773399,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To address a gap in translational research by developing a preclinical sheep model of medial meniscus anterior root (MAR) repair in vivo and to compare probabilities of potential pitfalls and difficulties with humans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Preoperative planning and surgical procedures applied to patients were adapted to adult sheep. Eight healthy, skeletally mature, female Merino ewes between 2 and 4 years of age underwent a mini\u2010open medial parapatellar approach to both stifle joints without luxating the patella. Next, the MAR was transected in 16 knees (8 sheep) resulting in a subtype 2A tear according to the LaPrade classification, followed by a transtibial pull\u2010out repair through a 3.2\u2009mm diameter bone tunnel with a reinforced Mason\u2013Allen suture and non\u2010absorbable suture material. Animals were followed until 21 days after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The surgery time per knee ranged between 30 and 50\u2009min (mean, 40.0\u2009\u00b1\u20097.8\u2009min). The surgical technique was safe without intra\u2010 or post\u2010operative complications. Solid repair is most likely if the following surgical principles are respected: (1) Selection of the MAR and the open technique allow for elegant tunnel positioning and less post\u2010operative loading stress due to the normal extension deficit of sheep; (2) careful preparation of the MAR is mandatory; (3) considering the oval shape of the MAR attachment (MARA) results in anatomic tunnel placement; (4) robust suture placement and configuration avoids suture cut out. The probabilities of potential pitfalls and difficulties differ from the human situation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A clinically adapted MAR repair model in adult sheep was developed following its complete transection close to the MARA, followed by an open transtibial pull\u2010out repair. The surgical technique was safe without intra\u2010 or short\u2010term post\u2010operative complications. This model may be suitable to study the biomechanics and pathophysiology of meniscal root injuries and their repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12636","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T02:23:45Z","timestamp":1743042225000},"page":"2487-2497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A new preclinical sheep model of medial meniscus anterior root repair: Part 2\u2014Surgical strategy, technical considerations, pearls and pitfalls"],"prefix":"10.1002","volume":"33","author":[{"given":"Matthias","family":"Brockmeyer","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Saarland University Medical Center, Saarland University Homburg Saarland 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