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Published on: June 3, 2020
Pretzel knot compared with standard suture knots.
Mustafa Karahan1, Umut Akgun, Ahu Turkoglu
1Department of Orthopedics and Traumatology, Marmara University School of Medicine, Istanbul, Turkey.
Summary
The Pretzel knot demonstrates comparable or superior biomechanical properties, including loop security, compared to commonly used arthroscopic surgical knots. This finding supports its potential for safe and effective use in arthroscopic procedures.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Surgical Techniques
Background:
- Arthroscopic knot tying is crucial for surgical success.
- Evaluating the biomechanical properties of surgical knots is essential for ensuring patient safety and procedural efficacy.
Purpose of the Study:
- To compare the biomechanical properties of the Pretzel knot against other established arthroscopic knots.
- To assess the mechanical safety and performance of the Pretzel knot in simulated surgical conditions.
Main Methods:
- Five arthroscopic knots (Pretzel, SMC, Giant, Dines, Nicky's, Tennessee Slider) were prepared using #2 braided polyester sutures.
- Knots were subjected to cyclic loading and load-to-failure tests to evaluate loop security, maximum elongation, and load at failure.
- The number of steps required for knot preparation was also recorded.
Main Results:
- The Pretzel knot, in its original configuration, exhibited significantly better loop security than SMC, Dines, Nicky's, and Tennessee knots (P=0.01).
- Load at failure did not differ significantly between original knot configurations, but Giant and Dines knots showed superior maximum elongation.
- Reinforcing knots with 3-RHAPs reduced most observed significant differences.
Conclusions:
- The Pretzel knot offers a simple yet mechanically robust option for arthroscopic knot tying.
- Its biomechanical properties are comparable or superior to widely used arthroscopic knots, suggesting clinical utility.
- The Pretzel knot presents a safe and effective alternative in arthroscopic surgery.
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