{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:53:20Z","timestamp":1777881200949,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pediatric patellofemoral instability is common, and medial patellofemoral ligament (MPFL) reconstruction is a highly effective treatment option. Femoral graft fixation methods include suture anchors (SAs) and interference screws (ISs), although comparative biomechanical studies in pediatric bone are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare the biomechanical properties of SA versus IS femoral graft fixation in pediatric MPFL reconstruction.<\/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>Ten fresh-frozen pediatric knees underwent femoral MPFL graft fixation using SA and IS (mean age, 9.5 years; range, 8-10 years). Posterior tibialis tendon allograft was used\u2009in\u2009both groups. For the IS group, 8-mm tunnels were drilled and 8 \u00d7 25\u2013mm biocomposite IS was used for graft fixation. For the SA group, a 1.8-mm knotless all-suture SA was placed and secured to the graft.\u2009Specimens were loaded\u2009onto an\u2009Instron 5944 and subjected to cyclic preconditioning, followed by an ultimate failure load at 6 mm\/s. The load displacement curve was then used to calculate stiffness (N\/mm). Data were analyzed using repeated-measures analysis of variance to account for multiple measurements on the same specimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      IS graft fixation demonstrated significantly higher ultimate failure load than SA (246.4 \u00b1 79.7 N vs 90.4 \u00b1 20.6 N,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Similarly, stiffness was significantly greater for IS compared to SA (17.8 \u00b1 4.1 N\/mm vs 13.4 \u00b1 2.2 N\/mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .009). All but 1 IS\u2009reconstruction failed by graft pullout from the femoral tunnel, whereas all 10 SA\u2009reconstructions failed by anchor pullout.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>IS offers significantly higher ultimate failure load and stiffness values compared to SA femoral MPFL graft fixation\u2009in\u2009human pediatric knees. Mean ultimate failure load values for femoral MPFL fixation\u2009in\u2009pediatric bone may be lower than\u2009in\u2009adult bone, based on comparative adult studies. These results provide initial biomechanical data comparing 2 commonly used femoral fixation methods in skeletally immature patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>This study characterized the biomechanical strength of SA and IS femoral MPFL fixation in pediatric bone, revealing differences in ultimate failure load and stiffness between constructs and compared to adult bone. While SA may pose less risk for growth alteration from physeal injury in younger patients, greater \u201ctime-zero\u201d MPFL fixation strength with IS may allow for accelerated rehabilitation and earlier return to sport, which is a key patient and family satisfaction variable. In some circumstances, SA fixation may be preferred due to physeal proximity, and postoperative therapy regimens may be modified to account for lower fixation strength. These findings can help surgeons optimize implant selection, tailor rehabilitation protocols, and minimize the risk of graft failure in skeletally immature patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261428088","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:24:33Z","timestamp":1775060673000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical Comparison of All-Suture Anchors Versus Interference Screws for Femoral Fixation in Pediatric MPFL Reconstruction"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1675-163X","authenticated-orcid":false,"given":"Amin M.","family":"Alayleh","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-9347","authenticated-orcid":false,"given":"Austin","family":"Stoner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Hollyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"McFarlane","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nneoma","family":"Duru","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wills","family":"Baird","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calvin","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5444-094X","authenticated-orcid":false,"given":"Henry B.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rady Children's Hospital San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8641-3150","authenticated-orcid":false,"given":"Marc","family":"Tompkins","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1306-4201","authenticated-orcid":false,"given":"Yi-Meng","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery &amp; Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-7835","authenticated-orcid":false,"given":"Theodore","family":"Ganley","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin G.","family":"Shea","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520966609"},{"issue":"1","key":"e_1_3_3_3_2","first-page":"24","article-title":"Biomechanical evaluation of lateral patellar dislocations","volume":"11","author":"Burks RT","year":"1998","unstructured":"Burks RT, Desio SM, Bachus KN, Tyson L, Springer K. 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