{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T10:16:34Z","timestamp":1773569794979,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the biomechanical properties of metallic anchor (MA) and all\u2010suture anchor (ASA) constructs in the anatomic reattachment of the lateral ulnar collateral ligament complex to its humeral insertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty paired male human cadaveric elbows with a mean age of 46.3 years (range: 33\u201058 years) were used in this study. Each pair was randomly allocated across 2 groups of either MA or ASA. A single 3.5\u2010mm MA or 2.6\u2010mm ASA was then inserted flush into the lateral epicondyle. A dynamic tensile testing machine was used to perform cyclic loading followed by a load to failure test. During the cyclic loading phase, the anchors were sinusoidally tensioned from 10 N to 100 N for 1,000 cycles at a frequency of 0.5 Hz. In the load to failure test, the anchors were pulled at a rate of 3 mm\/s. Load at 1\u2010mm and 2\u2010mm displacement, as well as load to ultimate failure were assessed. Clinical failure was defined as displacement of more than 2 mm. Normality of data was assessed with the Shapiro\u2010Wilk test. Continuous data are presented as medians and compared with the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test and categorical data was compared with the \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test or Fisher exact test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Displacement was significantly greater for the ASA group during cyclic loading starting from the tenth cycle (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Displacement of more than 5 mm within the first 100 cycles was observed in 2 anchors in the ASA group. No difference was observed in loads required to displace 1 mm (MA: 146 N [6\u2010169] vs ASA: 144 N [2\u2010153];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .53) and 2 mm (MA: 171 N [13\u2010202] vs ASA: 161 N [9\u2010191];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .97), but there was a statistically significant difference between ultimate loads in favor of ASA in the load to failure test (MA: 297 N [84\u2010343] vs 463 N [176\u2010620];\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the cyclic test, no difference in clinical failure defined as pull\u2010out of more than 2 mm was observed between 3.5 mm MAs and 2.6 mm ASAs. In the ultimate load to failure analysis, no difference was observed between groups in force causing 1 and 2 mm of displacement, but there was a significant difference in favor of ASA in the pull to ultimate failure test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Potential benefits of all\u2010suture anchors include preservation of bone stock, reduced radiographic artifacts, and easier revisions. Although their use has been investigated thoroughly in the shoulder, there remains a paucity of literature regarding displacement and pull\u2010out strength in the elbow.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2021.05.060","type":"journal-article","created":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T01:05:45Z","timestamp":1623459945000},"page":"2800-2806","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pullout Strength of All\u2010Suture and Metallic Anchors in Repair of Lateral Collateral Ligament Injuries of the\u00a0Elbow"],"prefix":"10.1002","volume":"37","author":[{"given":"Kaare S.","family":"Midtgaard","sequence":"first","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"Division of Orthopaedic Surgery Oslo University Hospital Oslo Norway"},{"name":"Norwegian Armed Forces Joint Medical Services Forsvarsvegen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip\u2010C.","family":"Nolte","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"BG Trauma Center Ludwigshafen at the University of Heidelberg Clinic for Trauma and Orthopaedic Surgery Ludwigshafen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon W.","family":"Miles","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kira K.","family":"Tanghe","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenton W.","family":"Douglass","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam A.","family":"Peebles","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew T.","family":"Provencher","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"Steadman Clinic Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001425"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-014-3471-7"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12306-016-0426-z"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00130911-200203000-00005"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00130911-200112000-00003"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.09.031"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117717010"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.10.024"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519860489"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2019.04.053"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2008.11.001"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.10.028"},{"issue":"1","key":"e_1_2_2_14_2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2106\/JBJS.D.02933","article-title":"Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. 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