{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T05:37:06Z","timestamp":1789882626752,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T00:00:00Z","timestamp":1614988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T00:00:00Z","timestamp":1614988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T00:00:00Z","timestamp":1614988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Dislocated tibial avulsions of the posterior cruciate ligament (PCL) require surgical intervention. Several arthroscopic strategies are options to fix the fragment and restore posterior laxity, including two types of suspension button devices: adjustable (self\u2010locking) and rigid knotted systems. Our hypothesis was that a rigid knotted button construct has superior biomechanical properties regarding laxity restoration compared with an adjustable system. Both techniques were compared with standard screw fixation and the native PCL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty porcine knees were dissected. The constructs were tested for elongation, stiffness, yield force, load to failure force, and failure mode in a material testing machine. Group N (native, intact PCL) was used as a control group. In group DB (Dogbone\u2122), TR (Tightrope\u2122), and S (screw), a standardized block osteotomy with the osteotomized fragment attached to the PCL was set. The DB and TR groups simulated using a suspension button system with either a rigid knotted (DB) or adjustable system (TR). These groups were compared to a screw technique (S) simulating antegrade screw fixation from posterior.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Comparing the different techniques (DB, TR, S), no significant elongation was detected; all techniques achieved a sufficient posterior laxity restoration. Significant elongation in the DB and TR group was detected compared with the native PCL (N). In contrast, screw fixation did not lead to significant elongation. The stiffness, yield load, and load to failure force did not differ significantly between the techniques. None of the techniques reached the same level of yield load and load to failure force as the intact state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Arthroscopic suspension button techniques sufficiently restore the posterior laxity and gain a comparable construct strength as an open antegrade screw fixation.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06510-1","type":"journal-article","created":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T07:03:03Z","timestamp":1615014183000},"page":"4163-4171","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Suspension button constructs restore posterior knee laxity in solid tibial avulsion of the posterior cruciate ligament"],"prefix":"10.1002","volume":"29","author":[{"given":"Philipp","family":"Forkel","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Buchmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J.","family":"Lang","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedics and Sport Orthopaedics, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"},{"name":"<!--<label>3<\/label>--> Chair of Non\u2010Destructive Testing, Department of Mechanical Engineering TU Munich Franz\u2010Langinger\u2010Stra\u00dfe 10 81245 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Burgkart","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedics and Sport Orthopaedics, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas B.","family":"Imhoff","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Mehl","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias J.","family":"Feucht","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Lutz","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schmitt","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopaedic Medicine, Klinikum Rechts Der Isar TU Munich Ismaninger Str. 22 81675 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,6]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2017.12.003"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010017\u20104769\u20102"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.01.006"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513507769"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2016010"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.10.013"},{"key":"e_1_2_9_8_2","unstructured":"ForkelP ImhoffAB AchtnichA WillingerLAll\u2010arthroscopic fixation of tibial posterior cruciate ligament avulsion fractures with a suture\u2010button 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July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"A. 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