Initial loop and knot security of arthroscopic knots using high-strength sutures

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Sports Medicine

Background:

• Arthroscopic surgery involves numerous knotting techniques and suture materials.
• Understanding knot and loop security is crucial for successful surgical outcomes.

Purpose of the Study:

• To evaluate the knot and loop security of common arthroscopic knots using three high-strength polyblend suture materials.
• To compare the performance of sliding versus nonsliding knot configurations.

Main Methods:

• Five arthroscopic knot configurations (Roeder, Weston, SMC, Tennessee Slider, Surgeon's knot) were tied using three No. 2 polyblend sutures (Fiberwire, Ultrabraid, Orthocord).
• Each knot-suture combination was tested eight times (120 total samples) to assess loop and knot security.
• A standardized protocol was used to compare the different knot types and suture materials.

Main Results:

• Orthocord demonstrated superior loop security, creating smaller knot loops on average.
• For knot security, Fiberwire and Ultrabraid generally outperformed Orthocord across sliding knot types (Roeder, Tennessee Slider, SMC).
• The nonsliding Surgeon's knot exhibited significantly lower mean loads to failure compared to all tested arthroscopic sliding knots.

Conclusions:

• Knot and loop security are significantly influenced by the choice of arthroscopic knot and suture material.
• Arthroscopic sliding knots provide superior security and strength compared to the nonsliding Surgeon's knot.
• Surgeons should favor sliding knots over the Surgeon's knot when utilizing polyblend suture materials for enhanced tissue fixation.