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We evaluated the mechanical repercussions of different medial row anchor configurations for that setting using different values of tension in the lateral row anchors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Knotless transosseous equivalent (TOE) rotator cuff repairs with locked versus nonlocked medial anchors and single versus double\u2010hole suture passage were tested in a synthetic rotator cuff mechanical model, using 2 different values of lateral row tension. Contact force, area, pressure, peak force and MBR force were compared at the simulated TBI using a pressure mapping sensor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When compared to locked anchors, medial row sliding configurations generate lower values for all the above\u2010mentioned parameters.<\/jats:p><jats:p>The use of double\u2010hole suture passage in the medial cuff generated slightly higher values contact area regardless of lateral row tension. At higher lateral row tension values, lower values of the remaining parameters, including MBR force, were found when compared to single\u2010hole suture passage.<\/jats:p><jats:p>Lateral row anchor tension increase induced an increase of all parameters regardless of the medial row configuration and TBI contact force and MBR force were the most susceptible parameters, regardless of the medial row pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Medial row mechanism, suture configuration and lateral row tension interfere with the mechanical force, area and pressure at by TBI. Lateral row tension increase is a major influencer in those parameters.<\/jats:p><jats:p>These results can help surgeons choose the right technique considering its mechanical effect at the TBI.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40634-022-00536-1","type":"journal-article","created":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T23:13:30Z","timestamp":1663542810000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanical consequences at the tendon\u2010bone interface of different medial row knotless configurations and lateral row tension in a simulated rotator cuff repair"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3407-7658","authenticated-orcid":false,"given":"Carlos","family":"Maia Dias","sequence":"first","affiliation":[{"name":"Department of Bioengineering and iBB \u2010 Institute for Bioengineering and Biosciences Instituto Superior T\u00e9cnico 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