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Related Experiment Video

Updated: Jul 4, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears

Published on: January 23, 2026

The DMD knot: a new locking, flip knot.

Joshua S Dines¹, Daniel Moynihan, Christopher Uggen

¹Kerlan Jobe Orthopaedic Clinic, Los Angeles, CA, USA. jdinesmd@gmail.com

Journal of Surgical Orthopaedic Advances

|June 14, 2008

Summary

Surgeons require arthroscopic knot-tying skills for rotator cuff and labral tear repairs. The DMD knot offers superior biomechanical performance and security compared to other configurations.

Area of Science:

Orthopedic Surgery
Biomechanical Engineering
Sports Medicine

Background:

Arthroscopic surgery for rotator cuff and labral tears necessitates proficient knot-tying techniques.
The biomechanical properties of surgical knots are critical for successful repair outcomes.
Numerous arthroscopic knot configurations exist, prompting comparative biomechanical assessments.

Purpose of the Study:

To present a detailed technique for tying the DMD knot, also known as the Dines knot.
To highlight the biomechanical advantages of the DMD knot in arthroscopic procedures.
To provide a valuable resource for surgeons seeking secure and reliable arthroscopic knotting methods.

Main Methods:

Review of existing literature on arthroscopic knot biomechanics.

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A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

Published on: January 13, 2026

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Last Updated: Jul 4, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears

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Published on: January 23, 2026

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

Published on: January 13, 2026

Detailed description of the DMD knot tying technique.

Discussion of biomechanical studies comparing the DMD knot to other configurations.

Main Results:

The DMD knot has demonstrated superior loop security and resistance to sliding in multiple studies.
It exhibits excellent knot security, high resistance to reverse slippage, and favorable knot weight.
The DMD knot has shown the greatest distance to failure among commonly used arthroscopic knots.

Conclusions:

The DMD knot is a highly secure and biomechanically robust option for arthroscopic rotator cuff and labral repairs.
Mastering the DMD knot technique is essential for surgeons performing advanced arthroscopic procedures.
This technique note provides clear instructions for reproducible and effective arthroscopic knot tying.