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Fish Mouth Closure of Horizontal Cleavage Tear of the Meniscus using Self-locking Modified Racking Hitch Knot (HitPat
Hitendra G Patil1, Milind V Pimprikar1, Chinar K Patil2
1Dr Pimprikar's ADTOOS Clinics, Nashik, Maharashtra, India.
Introduction:
Horizontal cleavage tears (HCT) of the meniscus are treated with fish-mouth closure with sutures using different methods. Using a no. 0 fiber wire and taking bites through both the flaps using a suture passing device and tying multiple knots is a cost-effective technique. A racking hitch knot is an option for all inside repairs of HCT. It needs multiple half hitches for locking the knot.
Surgical Technique:
We used a modification of the racking hitch knot (HP knot), making it a self-locking knot, so it does not need half hitches. Loop of no. 0 fiber wire is passed across both the flaps of the meniscus and a modified racking hitch knot tied in one goes closing the fish mouth.
Conclusion:
This modification (HP knot) saves operative time, it is cost-effective and has the distinct advantage of a reduction in the size of the final knot construct.
