{"id":"https://openalex.org/W7225780402","doi":"https://doi.org/10.21203/rs.3.rs-11000458/v1","title":"A novel needleless graft-grasping suture (Ram Knot) for ACL reconstruction: a biomechanical study","display_name":"A novel needleless graft-grasping suture (Ram Knot) for ACL reconstruction: a biomechanical study","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225780402","doi":"https://doi.org/10.21203/rs.3.rs-11000458/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11000458/v1","doi":"https://doi.org/10.21203/rs.3.rs-11000458/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11000458/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.21203/rs.3.rs-11000458/v1","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5110453257","display_name":"Ram Venkatesh","orcid":"https://orcid.org/0000-0003-1520-4172","observed_orcids":["https://orcid.org/0000-0003-1520-4172"]},"institutions":[{"id":"https://openalex.org/I2799390153","display_name":"Leeds Teaching Hospitals NHS Trust","ror":"https://ror.org/00v4dac24","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2799390153"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Ram Venkatesh","raw_affiliation_strings":["Leeds Teaching Hospitals NHS Trust"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Leeds Teaching Hospitals NHS Trust","institution_ids":["https://openalex.org/I2799390153"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110736037","display_name":"Tobi Oputa","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2803014302","display_name":"Royal Oldham Hospital","ror":"https://ror.org/030d91z44","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2803014302","https://openalex.org/I4405259061"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Tobi Oputa","raw_affiliation_strings":["Royal Oldham Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Royal Oldham Hospital","institution_ids":["https://openalex.org/I2803014302"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100736658","display_name":"Abhishek Singh","orcid":"https://orcid.org/0000-0002-4690-5118","observed_orcids":["https://orcid.org/0000-0002-4690-5118"]},"institutions":[{"id":"https://openalex.org/I2803014302","display_name":"Royal Oldham Hospital","ror":"https://ror.org/030d91z44","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2803014302","https://openalex.org/I4405259061"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Abhishek Kumar Singh","raw_affiliation_strings":["Royal Oldham Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Royal Oldham Hospital","institution_ids":["https://openalex.org/I2803014302"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000097182","display_name":"Haneen Abdullah Taha AL-Dulaimi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I60342839","display_name":"Qatar University","ror":"https://ror.org/00yhnba62","country_code":"QA","type":"education","lineage":["https://openalex.org/I60342839"]}],"countries":["QA"],"is_corresponding":false,"raw_author_name":"Haneen Aldulaimi","raw_affiliation_strings":["Qatar University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qatar University","institution_ids":["https://openalex.org/I60342839"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030155652","display_name":"Rohit Rambani","orcid":"https://orcid.org/0000-0001-8238-3604","observed_orcids":["https://orcid.org/0000-0001-8238-3604"]},"institutions":[{"id":"https://openalex.org/I4210145758","display_name":"Lancashire Care NHS Foundation Trust","ror":"https://ror.org/03zefc030","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I4210145758"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Rohit Rambani","raw_affiliation_strings":["Lancashire Care NHS Foundation Trust"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lancashire Care NHS Foundation Trust","institution_ids":["https://openalex.org/I4210145758"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5015102653","display_name":"Todd D. Stewart","orcid":"https://orcid.org/0000-0002-6868-9938","observed_orcids":["https://orcid.org/0000-0002-6868-9938"]},"institutions":[{"id":"https://openalex.org/I130828816","display_name":"University of Leeds","ror":"https://ror.org/024mrxd33","country_code":"GB","type":"education","lineage":["https://openalex.org/I130828816"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Todd Stewart","raw_affiliation_strings":["University of Leeds"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Leeds","institution_ids":["https://openalex.org/I130828816"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":5,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12906","display_name":"Surgical Sutures and Adhesives","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11068","display_name":"Tendon Structure and Treatment","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6101999878883362},{"id":"https://openalex.org/C2778434673","wikidata":"https://www.wikidata.org/wiki/Q611127","display_name":"Anterior cruciate ligament","level":2,"score":0.5579000115394592},{"id":"https://openalex.org/C170700871","wikidata":"https://www.wikidata.org/wiki/Q193378","display_name":"Biomechanics","level":2,"score":0.5419999957084656},{"id":"https://openalex.org/C203373105","wikidata":"https://www.wikidata.org/wiki/Q7880286","display_name":"Ultimate load","level":3,"score":0.5020999908447266},{"id":"https://openalex.org/C2777327002","wikidata":"https://www.wikidata.org/wiki/Q2865760","display_name":"Fibrous joint","level":2,"score":0.4657000005245209},{"id":"https://openalex.org/C107551265","wikidata":"https://www.wikidata.org/wiki/Q1458245","display_name":"Displacement (psychology)","level":2,"score":0.46299999952316284},{"id":"https://openalex.org/C2779372316","wikidata":"https://www.wikidata.org/wiki/Q569057","display_name":"Stiffness","level":2,"score":0.461899995803833},{"id":"https://openalex.org/C2780105995","wikidata":"https://www.wikidata.org/wiki/Q232358","display_name":"Tendon","level":2,"score":0.447299987077713},{"id":"https://openalex.org/C29694066","wikidata":"https://www.wikidata.org/wiki/Q118301","display_name":"Orthodontics","level":1,"score":0.4456000030040741},{"id":"https://openalex.org/C2776096238","wikidata":"https://www.wikidata.org/wiki/Q6130172","display_name":"Slippage","level":2,"score":0.44209998846054077},{"id":"https://openalex.org/C2776141760","wikidata":"https://www.wikidata.org/wiki/Q196002","display_name":"Hamstring","level":2,"score":0.43860000371932983},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3928000032901764},{"id":"https://openalex.org/C33947775","wikidata":"https://www.wikidata.org/wiki/Q271439","display_name":"Elongation","level":3,"score":0.38839998841285706},{"id":"https://openalex.org/C2988617437","wikidata":"https://www.wikidata.org/wiki/Q6627318","display_name":"Materials testing","level":2,"score":0.38679999113082886},{"id":"https://openalex.org/C180478085","wikidata":"https://www.wikidata.org/wiki/Q1973366","display_name":"Universal testing machine","level":3,"score":0.36079999804496765},{"id":"https://openalex.org/C146249460","wikidata":"https://www.wikidata.org/wiki/Q2914991","display_name":"Fixation (population genetics)","level":3,"score":0.35440000891685486},{"id":"https://openalex.org/C2778969670","wikidata":"https://www.wikidata.org/wiki/Q7880284","display_name":"Ultimate failure","level":3,"score":0.33379998803138733},{"id":"https://openalex.org/C2909158238","wikidata":"https://www.wikidata.org/wiki/Q196002","display_name":"Hamstring muscles","level":3,"score":0.32269999384880066},{"id":"https://openalex.org/C2779863119","wikidata":"https://www.wikidata.org/wiki/Q6423048","display_name":"Knot (papermaking)","level":2,"score":0.32019999623298645},{"id":"https://openalex.org/C136229726","wikidata":"https://www.wikidata.org/wiki/Q327092","display_name":"Biomedical engineering","level":1,"score":0.31690001487731934},{"id":"https://openalex.org/C3018344627","wikidata":"https://www.wikidata.org/wiki/Q1925224","display_name":"Failure mechanism","level":2,"score":0.3118000030517578},{"id":"https://openalex.org/C2986689482","wikidata":"https://www.wikidata.org/wiki/Q1806775","display_name":"Peak load","level":2,"score":0.30390000343322754},{"id":"https://openalex.org/C3018023364","wikidata":"https://www.wikidata.org/wiki/Q425265","display_name":"Significant difference","level":2,"score":0.29429998993873596},{"id":"https://openalex.org/C192562407","wikidata":"https://www.wikidata.org/wiki/Q228736","display_name":"Materials science","level":0,"score":0.2833999991416931},{"id":"https://openalex.org/C112950240","wikidata":"https://www.wikidata.org/wiki/Q76005","display_name":"Ultimate tensile strength","level":2,"score":0.2565999925136566},{"id":"https://openalex.org/C186068551","wikidata":"https://www.wikidata.org/wiki/Q13255585","display_name":"Tension (geology)","level":3,"score":0.25369998812675476}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11000458/v1","doi":"https://doi.org/10.21203/rs.3.rs-11000458/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11000458/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11000458/v1","doi":"https://doi.org/10.21203/rs.3.rs-11000458/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11000458/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":18,"referenced_works":["https://openalex.org/W1970909148","https://openalex.org/W1972549511","https://openalex.org/W2025974186","https://openalex.org/W2029470749","https://openalex.org/W2048100075","https://openalex.org/W2065622463","https://openalex.org/W2080847294","https://openalex.org/W2098053209","https://openalex.org/W2107778474","https://openalex.org/W2116120739","https://openalex.org/W2124644334","https://openalex.org/W2126915280","https://openalex.org/W2152503832","https://openalex.org/W2169164799","https://openalex.org/W3000207924","https://openalex.org/W3209044757","https://openalex.org/W4252874454","https://openalex.org/W4391074632"],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"This":[2],"study":[3],"describes":[4],"the":[5,31,210,222,236,248],"Ram":[6,50,241,281],"Knot,":[7],"a":[8,147,165,284],"novel":[9],"fully":[10],"needleless":[11],"graft-grasping":[12],"suture":[13,122],"technique":[14],"for":[15,290],"hamstring":[16,291],"tendon":[17,233,275],"autograft":[18],"preparation":[19,293],"in":[20,130,160,209,225,294],"anterior":[21],"cruciate":[22],"ligament":[23],"reconstruction":[24],"(ACLR)":[25],"comparing":[26],"its":[27],"biomechanical":[28,244],"performance":[29,245],"with":[30,200,252],"traditional":[32,249],"whipstitch":[33,54,250],"technique.":[34],"Methods":[35],"Porcine":[36],"flexor":[37],"tendons":[38],"(n":[39,56,72],"=":[40,57,73,188,197,214],"12)":[41],"were":[42,61,125,177],"standardised":[43],"and":[44,53,67,87,102,114,139,190,256,273,287],"randomly":[45],"allocated":[46],"to":[47,247],"two":[48],"groups:":[49],"Knot":[51,242,282],"(RK)":[52],"(WS)":[55],"6":[58],"each).":[59],"Specimens":[60],"subdivided":[62],"into":[63],"Single-Step":[64],"Testing":[65,69],"(SST)":[66],"Double-Step":[68],"(DST)":[70],"protocols":[71],"3":[74],"per":[75],"subgroup).":[76],"Biomechanical":[77],"testing":[78,85],"was":[79,205],"performed":[80],"using":[81],"an":[82],"Instron":[83],"mechanical":[84],"system":[86],"consisted":[88],"of":[89,221,270],"three":[90],"phases:":[91],"pre-tensioning":[92],"(10\u2013100":[93],"N),":[94,101,158],"cyclic":[95,135],"loading":[96],"(200":[97],"cycles":[98],"between":[99,137],"10\u2013200":[100],"load-to-failure":[103],"testing.":[104],"Outcome":[105],"measures":[106],"included":[107],"ultimate":[108,131],"failure":[109,115,132,150,168,194],"load,":[110],"elongation":[111,192,203],"(E1\u2013E3),":[112],"stiffness,":[113],"mode.":[116],"Results":[117],"All":[118],"specimens":[119],"failed":[120],"by":[121],"rupture.":[123],"There":[124],"no":[126],"statistically":[127,179],"significant":[128],"differences":[129,176],"load":[133,151,169],"or":[134],"displacement":[136],"RK":[138,153,163,182,211,226],"WS":[140,145,229],"groups.":[141],"In":[142,259],"SST":[143],"conditions,":[144],"demonstrated":[146,164,183,218],"higher":[148,166],"mean":[149,167],"than":[152],"(545.1":[154],"N":[155,171],"vs":[156,172],"423.5":[157],"whereas":[159,228],"DST":[161],"conditions":[162],"(382.5":[170],"359":[173],"N);":[174],"these":[175],"not":[178],"significant.":[180],"The":[181,240],"significantly":[184,207,253],"greater":[185],"stiffness":[186,255],"(p":[187,196,213],"0.004)":[189],"reduced":[191,257,274],"at":[193,235],"(E3)":[195],"0.007)":[198],"compared":[199],"WS.":[201],"Pre-tension":[202],"(E1)":[204],"also":[206],"lower":[208],"group":[212],"0.025).":[215],"Qualitative":[216],"analysis":[217],"minimal":[219],"slippage":[220],"primary":[223],"loop":[224],"constructs,":[227],"constructs":[230],"exhibited":[231],"progressive":[232],"damage":[234],"suture\u2013tendon":[237],"interface.":[238],"Conclusion":[239],"demonstrates":[243],"comparable":[246],"technique,":[251],"increased":[254],"elongation.":[258],"addition,":[260],"it":[261],"provides":[262],"practical":[263],"advantages":[264],"including":[265],"faster":[266],"graft":[267,292],"preparation,":[268],"elimination":[269],"needle":[271],"passes,":[272],"damage.":[276],"These":[277],"findings":[278],"suggest":[279],"that":[280],"represents":[283],"mechanically":[285],"reliable":[286],"efficient":[288],"alternative":[289],"ACL":[295],"reconstruction.":[296]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}
