{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:21:02Z","timestamp":1789269662570,"version":"build-2803163510"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T00:00:00Z","timestamp":1580774400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T00:00:00Z","timestamp":1580774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Ministerio de Ciencia, Innovacion y Universidades (Ministry of Science, Innovation and Universities), Spain"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The importance of meniscal root integrity to preserve contact load distribution and stability at the knee joint is recognised. Transosseous suture technique is commonly used to repair meniscal root tears. However, clinical results are not completely satisfactory. Specifically, concern exists about the development of substantial displacements at the repaired root. This study aims to assess if the use of a post-insertion tensioning knotless-anchor at the distal exit of the tibial tunnel improves time-zero biomechanical properties of the transtibial repair compared to knotting sutures over a cortical button. Twenty porcine tibia with detached posterior medial meniscal roots were randomized into two groups depending on the method to fix the sutures after root repair: knotless-anchor (KA) or suture-button (SB). Specimens underwent cyclic and load-to-failure testing. Group KA showed significantly smaller residual root displacements after low-level repetitive loads. At the load-to-failure test, Group KA exhibited significantly lower displacements at representative subcritical loads and higher resistance to development of clinically relevant displacements. The authors conclude that use of a knotless suture anchor attached at the distal outlet of the bone tunnel may be an effective solution to reduce root displacements in transtibial meniscal root repairs, a matter reported to alter biomechanics of joint contact.<\/jats:p>","DOI":"10.1038\/s41598-020-58656-6","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T11:02:47Z","timestamp":1580814167000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Initial Biomechanical Properties of Transtibial Meniscal Root Repair are Improved By Using a Knotless Anchor as a Post-Insertion Tensioning Device"],"prefix":"10.1038","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2639-0452","authenticated-orcid":false,"given":"Maria","family":"Prado-Novoa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6405-0515","authenticated-orcid":false,"given":"Ana","family":"Perez-Blanca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5812-7627","authenticated-orcid":false,"given":"Alejandro","family":"Espejo-Reina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jose","family":"Espejo-Reina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Espejo-Baena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,4]]},"reference":[{"key":"58656_CR1","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.2106\/JBJS.G.00748","volume":"90","author":"R Allaire","year":"2008","unstructured":"Allaire, R., Muriuki, M., Gilbertson, L. & Harner, C. D. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J. Bone Jt. Surg. Am. 90, 1922\u20131931, https:\/\/doi.org\/10.2106\/JBJS.G.00748 (2008).","journal-title":"J. Bone Jt. Surg. Am."},{"key":"58656_CR2","doi-asserted-by":"publisher","first-page":"471","DOI":"10.2106\/JBJS.L.01252","volume":"96","author":"CM LaPrade","year":"2014","unstructured":"LaPrade, C. M. et al. Altered tibiofemoral contact mechanics due to lateral meniscus posterior horn root avulsions and radial tears can be restored with in situ pull-out suture repairs. J. Bone Jt. Surg. Am. 96, 471\u2013479, https:\/\/doi.org\/10.2106\/JBJS.L.01252 (2014).","journal-title":"J. Bone Jt. Surg. Am."},{"key":"58656_CR3","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1177\/0363546513499314","volume":"42","author":"JR Padalecki","year":"2014","unstructured":"Padalecki, J. R. et al. Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am. J. Sports Med. 42, 699\u2013707, https:\/\/doi.org\/10.1177\/0363546513499314 (2014).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR4","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1016\/j.arthro.2015.08.040","volume":"32","author":"A Perez-Blanca","year":"2016","unstructured":"Perez-Blanca, A. et al. Comparative Biomechanical Study on Contact Alterations after Lateral Meniscus Posterior Root Avulsion, Transosseous Reinsertion, and Total Meniscectomy. Arthroscopy 32, 624\u2013633, https:\/\/doi.org\/10.1016\/j.arthro.2015.08.040 (2016).","journal-title":"Arthroscopy"},{"key":"58656_CR5","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1177\/0363546514563910","volume":"43","author":"TB Shybut","year":"2015","unstructured":"Shybut, T. B. et al. Effect of lateral meniscal root tear on the stability of the anterior cruciate ligament-deficient knee. Am. J. Sports Med. 43, 905\u2013911, https:\/\/doi.org\/10.1177\/0363546514563910 (2015).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR6","doi-asserted-by":"publisher","first-page":"3016","DOI":"10.1177\/0363546514524162","volume":"42","author":"S Bhatia","year":"2014","unstructured":"Bhatia, S., LaPrade, C. M., Ellman, M. B. & LaPrade, R. F. Meniscal Root Tears: Significance, Diagnosis, and Treatment. Am. J. Sports Med. 42, 3016\u20133030, https:\/\/doi.org\/10.1177\/0363546514524162 (2014).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.4081\/or.2015.5792","volume":"7","author":"DE Bonasia","year":"2015","unstructured":"Bonasia, D. E., Pellegrino, P., D\u2019Amelio, A., Cottino, U. & Rossi, R. Meniscal Root Tear Repair: Why, When and How? Orthop. Rev. 7, 34\u201339, https:\/\/doi.org\/10.4081\/or.2015.5792 (2015).","journal-title":"Orthop. Rev."},{"key":"58656_CR8","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1177\/0363546518755754","volume":"47","author":"SC Faucett","year":"2019","unstructured":"Faucett, S. C. et al. Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears Clinical and Economic Effectiveness. Am. J. Sports Med. 47, 762\u2013769, https:\/\/doi.org\/10.1177\/0363546518755754 (2019).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR9","doi-asserted-by":"publisher","first-page":"2988","DOI":"10.1177\/0363546514549447","volume":"42","author":"Cerminara","year":"2014","unstructured":"Cerminara et al. Biomechanical evaluation of a transtibial pull-out meniscal root repair: challenging the bungee effect. Am. J. Sports Med. 42, 2988\u2013299, https:\/\/doi.org\/10.1177\/0363546514549447 (2014).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR10","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1177\/0363546513502946","volume":"42","author":"MJ Feucht","year":"2014","unstructured":"Feucht, M. J. et al. Biomechanical comparison between suture anchor and transtibial pull-out repair for posterior medial meniscus root tears. Am. J. Sports Med. 42, 187\u2013193, https:\/\/doi.org\/10.1177\/0363546513502946 (2014).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR11","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.arthro.2012.09.004","volume":"29","author":"C St\u00e4rke","year":"2013","unstructured":"St\u00e4rke, C., Kopf, S., Lippisch, R., Lohman, C. H. & Becker, R. Tensile forces on repaired medial meniscal root tears. Arthroscopy 29, 205\u2013212, https:\/\/doi.org\/10.1016\/j.arthro.2012.09.004 (2013).","journal-title":"Arthroscopy"},{"key":"58656_CR12","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1177\/0363546514566191","volume":"43","author":"CM LaPrade","year":"2015","unstructured":"LaPrade, C. M. et al. Biomechanical consequences of a nonanatomic posterior medial meniscal root repair. Am. J. Sports Med. 43, 912\u2013920, https:\/\/doi.org\/10.1177\/0363546514566191 (2015).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR13","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1007\/s00264-018-3799-9","volume":"42","author":"A P\u00e9rez-Blanca","year":"2018","unstructured":"P\u00e9rez-Blanca, A., Prado N\u00f3voa, M., Lombardo Torre, M., Espejo-Reina, A. & Espejo-Baena, A. The role of suture cutout in the failure of meniscal root repair during the early post-operative period: a biomechanical study. Int. Orthop. 42, 811\u2013818, https:\/\/doi.org\/10.1007\/s00264-018-3799-9 (2018).","journal-title":"Int. Orthop."},{"key":"58656_CR14","doi-asserted-by":"publisher","first-page":"2407","DOI":"10.1177\/0363546508323745","volume":"36","author":"OA Ilahi","year":"2008","unstructured":"Ilahi, O. A., Younas, S. A., Ho, D. M. & Noble, P. C. Security of knots tied with ethibond, fiberwire, orthocord, or ultrabraid. Am. J. Sports Med. 36, 2407\u20132414, https:\/\/doi.org\/10.1177\/0363546508323745 (2008).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR15","doi-asserted-by":"publisher","first-page":"15","DOI":"10.4103\/0973-6042.174513","volume":"10","author":"SW Hill","year":"2016","unstructured":"Hill, S. W. et al. Biomechanical evaluation of the Nice knot. Int. J. Shoulder Surg. 10, 15\u201320, https:\/\/doi.org\/10.4103\/0973-6042.174513 (2016).","journal-title":"Int. J. Shoulder Surg."},{"key":"58656_CR16","doi-asserted-by":"publisher","first-page":"e621","DOI":"10.1016\/j.eats.2017.01.006","volume":"6","author":"A Espejo-Baena","year":"2017","unstructured":"Espejo-Baena, A. et al. Transosseous Posterior Meniscal Root Reinsertion Using Knotless Anchor for Tibial Fixation. Arthrosc. Tech. 6, e621\u2013e626, https:\/\/doi.org\/10.1016\/j.eats.2017.01.006 (2017).","journal-title":"Arthrosc. Tech."},{"key":"58656_CR17","doi-asserted-by":"publisher","first-page":"e511","DOI":"10.1016\/j.eats.2016.11.006","volume":"6","author":"JM Woodmass","year":"2017","unstructured":"Woodmass, J. M., Mohan, R., Stuart, M. J. & Krych, A. J. Medial Meniscus Posterior Root Repair Using a Transtibial Technique. Arthrosc. Tech. 6, e511\u2013e516, https:\/\/doi.org\/10.1016\/j.eats.2016.11.006 (2017).","journal-title":"Arthrosc. Tech."},{"key":"58656_CR18","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1177\/0363546514562554","volume":"43","author":"RF LaPrade","year":"2015","unstructured":"LaPrade, R. F. et al. Cyclic displacement after meniscal root repair fixation: a human biomechanical evaluation. Am. J. Sports Med. 43, 892\u2013898, https:\/\/doi.org\/10.1177\/0363546514562554 (2015).","journal-title":"Am. J. Sports Med."},{"key":"58656_CR19","doi-asserted-by":"publisher","first-page":"e85","DOI":"10.1016\/j.arthro.2004.07.006","volume":"20","author":"A Espejo-Baena","year":"2004","unstructured":"Espejo-Baena, A., Urbano-Labajos, V., Ruiz del Pino, M. J. & Peral-Infantes, I. A simple device for inside-out meniscal suture. Arthroscopy. 20, e85\u2013e87, https:\/\/doi.org\/10.1016\/j.arthro.2004.07.006 (2004).","journal-title":"Arthroscopy."},{"key":"58656_CR20","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.clinbiomech.2007.11.016","volume":"23","author":"W Mesfar","year":"2008","unstructured":"Mesfar, W. & Shirazi-Adl, A. Knee joint biomechanics in open-kinetic-chain flexion exercises. Clin. Biomech. 23, 477\u2013482, https:\/\/doi.org\/10.1016\/j.clinbiomech.2007.11.016 (2008).","journal-title":"Clin. Biomech."},{"key":"58656_CR21","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s00167-016-4237-4","volume":"25","author":"P Forkel","year":"2017","unstructured":"Forkel, P. et al. Biomechanical and viscoelastic properties of different posterior meniscal root fixation techniques. Knee Surg. Sports Traumatol. Arthrosc. 25, 403\u2013410, https:\/\/doi.org\/10.1007\/s00167-016-4237-4 (2017).","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"58656_CR22","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1007\/s00167-013-2656-z","volume":"23","author":"MJ Feucht","year":"2015","unstructured":"Feucht, M. J. et al. Biomechanical evaluation of different suture materials for arthroscopic transtibial pull-out repair of posterior meniscus root tears. Knee Surg. Sports Traumatol. Arthrosc. 23, 132\u201313, https:\/\/doi.org\/10.1007\/s00167-013-2656-z (2015).","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"58656_CR23","doi-asserted-by":"publisher","first-page":"2164","DOI":"10.1016\/j.jbiomech.2010.03.04","volume":"43","author":"I Kutzner","year":"2010","unstructured":"Kutzner, I. et al. Loading of the knee joint during activities of daily living measured in vivo in five subjects. J. Biomech. 43, 2164\u20132173, https:\/\/doi.org\/10.1016\/j.jbiomech.2010.03.04 (2010).","journal-title":"J. Biomech."},{"key":"58656_CR24","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/j.arthro.2009.08.013","volume":"26","author":"C St\u00e4rke","year":"2010","unstructured":"St\u00e4rke, C., Kopf, S., Grobel, K. & Becker, R. The effect of a non-anatomical repair of the meniscal horn attachment on meniscal tension: a biomechanical study. Arthroscopy 26, 358\u2013365, https:\/\/doi.org\/10.1016\/j.arthro.2009.08.013 (2010).","journal-title":"Arthroscopy"},{"key":"58656_CR25","doi-asserted-by":"crossref","unstructured":"Faul, F., Erdfelder, E., Lang, A. G. & Buchner, A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 39, 175\u2013191 PMID: 17695343 (2007).","DOI":"10.3758\/BF03193146"},{"key":"58656_CR26","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1177\/0363546509332816","volume":"37","author":"KG Swan Jr.","year":"2009","unstructured":"Swan, K. G. Jr., Baldini, T. & McCarty, E. C. Arthroscopic Suture Material and Knot Type. An Updated Biomechanical Analysis. Am. J. Sports. Med. 37, 1578\u20131585, https:\/\/doi.org\/10.1177\/0363546509332816 (2009).","journal-title":"Am. J. Sports. Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-58656-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-58656-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-58656-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T14:57:37Z","timestamp":1672671457000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-58656-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,4]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["58656"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-58656-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,4]]},"assertion":[{"value":"19 September 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1748"}}