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A biomechanical comparison of arthroscopic sliding and sliding-locking knots.
Elkousy, Hussein A; Sekiya, Jon K; Stabile, Kathryne J; McMahon, Patrick J.
Afiliación
  • Elkousy HA; Fondren Orthopedic Group, Sugar Land, Texas, USA.
Arthroscopy ; 21(2): 204-10, 2005 Feb.
Article en En | MEDLINE | ID: mdl-15689871
PURPOSE: To evaluate biomechanical characteristics of 3 arthroscopic sliding and sliding-locking knots and the square knot, the gold standard used in open surgery. TYPE OF STUDY: Biomechanical investigation. METHODS: Four different knot types (Weston, square, Duncan loop, and Nicky's) were tested in 5 configurations in a closed-loop system on a materials testing device. Three of the 5 knots were backed up with 3 reverse half-hitches and alternating posts and all sliding and sliding-locking knots were tied using an arthroscopic technique. Twelve knots of each configuration were tested for loop security with a 7-N preload, and for knot security with load to failure at a strain rate of 1.25 mm/second and cyclic loading of a 30-N force for 50 cycles. RESULTS: No knots subjected to the 7-N preload failed or slipped and all had similar elongation (0.1 +/- 0.1 mm) except Nicky's knot (0.3 +/- 0.2 mm). There was no significant difference in load at failure for the square knot (178 +/- 14 N), the Weston knot backed with 3 half-hitches (168 +/- 14 N), the Duncan loop (160 +/- 20 N), or Nicky's knot (148 +/- 13 N). Most knots with 3 half-hitches failed with rupture at the knot. Under cyclic loading, no knots failed and none elongated greater than an average of 0.3 mm. CONCLUSIONS: All knot configurations maintained high loop security. All sliding and sliding-locking knots backed with 3 half-hitches had load at failure comparable to the square knot. With cyclic load testing, all knots tested elongated minimally. Additionally, this study confirms that all knots, even the sliding-locking Weston knot, are best backed up with 3 half-hitches alternating posts and directions of the throws. CLINICAL RELEVANCE: Sliding and sliding-locking knots are becoming increasingly popular among arthroscopic shoulder surgeons. This study provides a biomechanical basis for the clinical use of these arthroscopic knots and compares them with the gold standard, the open square knot.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroscopía / Técnicas de Sutura Límite: Humans Idioma: En Revista: Arthroscopy Asunto de la revista: ORTOPEDIA Año: 2005 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroscopía / Técnicas de Sutura Límite: Humans Idioma: En Revista: Arthroscopy Asunto de la revista: ORTOPEDIA Año: 2005 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos