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Related Concept Videos

Sutures of the Skull01:22

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Related Experiment Video

Updated: Feb 9, 2026

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears
06:41

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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Knotless Fixation Is Stronger and Less Variable Than Knotted Constructs in Securing a Suture Loop.

Patrick J Denard1, Christopher R Adams2,3, Nicole C Fischer4

  • 1Southern Oregon Orthopedics, Medford, Oregon, USA.

Orthopaedic Journal of Sports Medicine
|May 31, 2018
PubMed
Summary
This summary is machine-generated.

Knotless fixation using suture tape offers superior biomechanical strength and reduced surgeon variability compared to traditional knotted repairs or knotless repairs with standard suture. This advancement improves rotator cuff repair outcomes.

Keywords:
knot securityknot tyingknotless fixationloop security

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Last Updated: Feb 9, 2026

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

  • Orthopaedic Surgery
  • Biomedical Engineering
  • Sports Medicine

Background:

  • Tendon-to-bone fixation traditionally relies on surgeon-dependent knot tying.
  • Significant variability in the strength of knotted repairs exists among surgeons.

Purpose of the Study:

  • To compare the biomechanical properties of knotted versus knotless tendon fixation.
  • To assess surgeon variability in performing both knotted and knotless constructs.
  • Hypothesized that knotless constructs would demonstrate superior strength and reduced variability.

Main Methods:

  • Controlled laboratory study involving 34 orthopaedic surgeons.
  • Evaluated 104 knotted constructs (No. 2 suture), 21 knotless constructs (K2 group, No. 2 suture), and 79 knotless constructs (KT group, suture tape).
  • Mechanical testing assessed load at 3 mm displacement, load to failure, and construct stiffness.

Main Results:

  • The suture tape knotless (KT) group exhibited the greatest mean load at 3 mm displacement, load to failure, and stiffness.
  • Knotless fixation, particularly with suture tape, demonstrated significantly less variability in load to failure compared to knotted constructs.
  • The knotted group showed greater variability (SD, 94 N) than the KT (SD, 38 N) and K2 (SD, 17 N) groups.

Conclusions:

  • Knotless fixation with suture tape provides enhanced biomechanical performance over knotted repairs and knotless repairs using standard suture.
  • Knotless fixation techniques reduce variability in biomechanical properties across multiple surgeons.
  • Findings are relevant for surgical technique selection and rotator cuff repair construct design.