[Thermal knot fixation]

Knots represent the weakest point in suture material. As a result of bending and tension, forces develop within the knot that exceed the strength of the suture material and lead to rupture. Furthermore, because of their relatively large surface area, the most pronounced reactions occur in the vicinity of knots. The results of in vitro experiments conducted with the aim of improving the strength of knots are reported. The knot holding capacity of polypropylene filaments (EP 5/USP 2) was determined at room temperature (22 degrees C) after exposure to temperatures of 63, 98 and 150 degrees C. Knots that were exposed to a temperature of 98 degrees C for 10 seconds had a 50% higher holding capacity than untreated knots. With a higher knot holding capacity, secure fixation can be achieved with fewer knots. Since fewer knots have a smaller surface area, a reduction in tissue reaction may be expected.