## 4 Discussion
It must be highlighted that in cases where more than one suture is employed, inevitable asymmetries in traction distribution may occur. Consequently, when the interface of one stitch reaches the tension threshold, initiating tearing, it is highly probable that the other stitches are at a lower load level. [PERSON] et al. found a mean ultimate force of 58.2 \(\pm\) 29.6 N when testing posterior horns of human medial menisci (ages 48 to 88 years) with one simple stitch [38]. The lower values observed may be attributed to their use of a #0 UHMWPE surgical suture, implying a thinner suture diameter and resistant area than in our study. Unfortunately, meniscus thickness was not reported, which does not permit us to estimate \(S_{c}\) in that study. [PERSON] et al. tested posterior human menisci aged 18-51 years in a load-to-failure test with two #2 single UHMWPE sutures, finding an ultimate load of 64.10 \(\pm\) 22.50 N [53]. This value is considerably lower than other works and our younger group, factoring in the difference from the use of a single stitch. Concerning meniscal horn elasticity, few studies have specifically addressed deformation at the sutured horn [29; 46]. While some biomechanical works have reported on meniscus-suture construct stiffness, the results vary widely, even when restricted to UHMWPE threads. Stiffness for two simple sutures ranged from 774 \(\pm\) 730 N/mm [38] using suture #0 to 24.55 \(\pm\) 4.05 N/mm [52] with #2 sutures. Dispersion may be due to differences in suture thread lengths, which are often unreported, and varied cyclic loading histories before the load-to-failure test, which are known to influence the elasticity of surgical sutures if insufficient resting time is allowed [54]. Our results for the porcine model fall within the previously published range of failure loads. However, it is noteworthy that the range of published data is considerably wide. In a study where a meniscus was also sutured with a single simple stitch, utilizing a UHMWPE #2 suture [17], an ultimate load of 169 \(\pm\) 73.4 N was reported. The result aligns with our outcome of 206.79 \(\pm\) 74.31 N, considering that in that study, the specimens were pre-weakened with 1000 cycles of load between 5 and 20 N. In contrast, other tests involving porcine models yielded results for two sutures ranging from 129.8 \(\pm\) 14.6 N [19] to 221.67 \(\pm\) 43 N [29], although various suturing techniques and suture materials were employed. Beyond the variations attributed to different testing protocols, these disparities may be attributed to the diverse origin of the animal. While animal surrogate models provide the advantage of ensuring uniformity among donors, variations in breeds, types of feeding, stabling conditions, etc., can introduce significant differences between groups of diverse origins, even if they belong to the same species. This concern has been previously raised, and we believe it warrants further investigation [55]. In a study by [PERSON] et al., a comparison of the cyclic stiffness and ultimate load in load-to-failure tests on posterior horns of humans aged 50-70 years and porcine samples was undertaken [35]. Specimens sutured with three simple stitches using #2 UHMWPE threads were subjected to 1000 cycles of loading ranging from 10 N to 30 N, followed by a load-to-failure test. The study reports a 2.4-times-higher ultimate load for the porcine model compared to the human model, which is consistent with our findings of a 2.7-times-higher \(F_{u}\) for the porcine model compared to the younger human model, with no previous cyclic loading that may have weakened the tissue. Their human model also exhibited lower cyclic stiffness of the meniscus-suture construct in contrast to our results, which did not find any differences in deformation. However, the parameters are not comparable because our study was limited to the meniscus around the suture area, and we performed a direct load-to-failure test. The mechanical properties of sutured meniscal tissue have not been studied so far.