A new technique for small and secure knots using slippery polyethylene sutures

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Sports Medicine

Background:

• Suture knots in tendon surgery require high strength and minimal bulk to ensure proper gliding.
• A unique "antislip" knot was developed to address these requirements.

Purpose of the Study:

• To evaluate the tensile strength and volume of a novel antislip knot compared to a conventional reef knot.
• To assess the effectiveness of the antislip knot with different suture materials and throws.

Main Methods:

• Three suture materials (Ethibond, Fiberwire, Nespron) were tested.
• Knots were tied using either the antislip or a conventional reef knot technique with United States Pharmacopeia (USP) 2 sutures.
• Knot volume and tensile strength were measured for 25 replicates per condition.

Main Results:

• Antislip knots with Fiberwire and Nespron sutures demonstrated high tensile strength, with no significant difference between 5- and 6-throw configurations.
• Tensile strength per volume was significantly higher (over 1.25-fold) for 4- and 5-throw antislip knots with Fiberwire and Nespron compared to reef knots.
• Ethibond sutures exhibited lower tensile strength compared to Fiberwire and Nespron.

Conclusions:

• The antislip knot provides comparable or greater strength in a smaller volume than conventional reef knots.
• The 4- or 5-throw antislip knot is particularly effective for slippery polyethylene sutures.
• This knot design has the potential to improve tendon healing and facilitate faster rehabilitation.