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Related Experiment Videos

Cyclic testing of arthroscopic knot security.

Omer A Ilahi1, Shiraz A Younas, Jerry Alexander

  • 1Texas Arthroscopy and Sports Medicine Institute, Houston, Texas, USA. oilahi@mysurgeon.com

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|January 13, 2004
PubMed
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Knot security is crucial for arthroscopic repairs. Modified Revo knots offer durability comparable to traditional square knots, while other arthroscopic knots show variable or poor performance under cyclic loading.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Materials Science

Background:

  • Arthroscopic soft tissue repairs require secure knots to withstand cyclic loading before healing.
  • Knot security is paramount for successful surgical outcomes in arthroscopy.

Purpose of the Study:

  • To evaluate the security of different arthroscopic knot configurations under stepwise cyclic loading.
  • To compare the performance of arthroscopic knots against traditional square knots.

Main Methods:

  • In vitro materials testing of three arthroscopic knot types (sliding, modified Revo, SMC) and open-tied square knots.
  • Knots were subjected to cyclic loading from 10 N to 120 N, with 250 cycles at each load level.
  • Initial displacement, permanent laxity, and ultimate failure load were recorded for each knot type.

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Main Results:

  • All tested arthroscopic slip knots exhibited significantly less initial displacement than square knots.
  • Modified Revo knots demonstrated durability comparable to square knots, resisting loosening under cyclic loads.
  • Arthroscopic knots without post switching showed highly variable security, with some failing early in cyclic testing.

Conclusions:

  • Post switching and loop reversal are critical for enhancing arthroscopic knot security.
  • The modified Revo knot is a reliable option, performing similarly to open-tied square knots.
  • Variable security in some arthroscopic knots highlights the need for careful technique and knot selection.