{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:50:12Z","timestamp":1777881012581,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007308","name":"arthrex gmbh","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007308","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Optimized surgical fixation and meniscal stabilization during rehabilitation increase healing success. However, the latest generation of all-inside devices has not yet been biomechanically compared with inside-out suture tape (IO-ST) repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>(1) The contact area of a suture anchor (SA) would compensate for a meniscal defect better than polyether ether ketone anchors (PA); (2) adjustable tensioning for all-inside meniscal repair fixation would result in higher initial load than IO-ST repair; and (3) stiffer constructs would decrease secondary displacement.<\/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>Methods:<\/jats:title>\n                    <jats:p>This study investigates human menisci (N = 39) via microscopic imaging and a biomechanical testing protocol. For the imaging protocol, needles of an all-inside SA or PA device and an IO-ST device were inserted after staining to measure the iatrogenic defect created by the needle insertion (n = 20) and the length, width, and meniscus contact area of deployed all-inside anchors (n = 6). For biomechanical testing, menisci with longitudinal bucket handle tears were prepared, and single stitches were repaired (each n = 9). After suture tensioning (50 N) and fixation, initial load, initial stiffness, and relief displacement were measured. Constructs underwent cyclic loading between 2 and 20 N, with 10,000 cycles (0.75 Hz), and stiffness and displacement were measured. Ultimate stiffness and load-to-failure were analyzed at 3.15 mm\/sec.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All-inside needles created greater iatrogenic meniscal defects (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) than IO-ST repair. While PAs were longer (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), SAs were wider with a greater meniscal contact area (both\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). IO-ST repair resulted in the lowest initial load (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and relief displacement (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), whereas SA repair resulted in a higher initial load (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .007) and stiffness (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .023) than PA repair. The overall stiffer SA fixation (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 001) significantly reduced cyclic displacement compared with other repairs (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .044). The PA group failed due to an anchor fracture at a significantly lower load (84.3 \u00b1 10.7 N;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) than the IO-ST (136.4 \u00b1 10.5 N) and the SA repair (122.1 \u00b1 17.5 N), with a suture-based failure mode. The ultimate stiffness of SA constructs was higher (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .045) than that of other repairs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While all-inside devices showed improved primary stability, the IO-ST construct demonstrated the highest load-to-failure. In a human cadaveric model, meniscal repair with a more compact and conforming SA was stiffer and reduced cyclic displacement compared with PA and IO-ST repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>All-inside SA repair improved primary stability. Future clinical series will define the overall significance of healing rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251371295","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T11:30:17Z","timestamp":1759923017000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Fixation of Single Stitch All-Inside and Inside-Out Meniscal Devices for Repairing Vertical Longitudinal Meniscal Tears: A Human Microscopic Imaging and Biomechanical Study"],"prefix":"10.1177","volume":"13","author":[{"given":"Samuel","family":"Bachmaier","sequence":"first","affiliation":[{"name":"Arthrex Department of Orthopedic Research, Munich, Bavaria, Germany"},{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich, University Hospital, LMU Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3248-8007","authenticated-orcid":false,"given":"Aaron J.","family":"Krych","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8806-9384","authenticated-orcid":false,"given":"Romain","family":"Seil","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Missouri, Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asheesh","family":"Bedi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Woiczinski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich, University Hospital, LMU Munich, Germany"},{"name":"Experimental Orthopaedics University Hospital Jena, Campus Eisenberg, Friedrich-Schiller-University, Waldkliniken, Eisenberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1831-6161","authenticated-orcid":false,"given":"Coen A.","family":"Wijdicks","sequence":"additional","affiliation":[{"name":"Arthrex Department of Orthopedic Research, Munich, Bavaria, 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