A biomechanical comparison of arthroscopic sliding and sliding-locking knots.
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.
Buscar en Google
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