title: The kinematics and kinetics of slipknots for arthroscopic Bankart repair.
abstract: An apparatus has been developed to enable the in vitro measurement of the kinematics and kinetics of a slipknot, both while the knot is being tightened and with the knot in place and the tension removed. During tightening, the apparatus provides a linearly increasing resistance, which may be considered analogous to the resistance experienced when the labrum is drawn toward and apposed to the edge of the glenoid cavity during a Bankart repair. The tension to close the knot is measured with a tensiometer, in tandem with the closure of the capsule model onto the bone anchor, which is measured with a datalogger. The tightening tension was limited to 25 N and intraoperator and interoperator comparisons were made for four knots tied by six participants. Failure of a knot was taken to be reverse slippage of 2 mm. A second criterion of ease of slide was used to assess each knot. We found wide interoperator variability with regard to slipknot tying. A methodology for quality control of slipknot tying is presented.
authors.affiliation: Department of tMusculoskeletal Science, Royal Liverpool University Hospital, United Kingdom.
authors.forename: P J
authors.initials: PJ
authors.lastname: Hughes
authors.forename: R P
authors.initials: RP
authors.lastname: Hagan
authors.forename: A C
authors.initials: AC
authors.lastname: Fisher
authors.forename: E M
authors.initials: EM
authors.lastname: Holt
authors.forename: S P
authors.initials: SP
authors.lastname: Frostick
mesh_terms: D001182:Arthroscopy; D001696:Biomechanical Phenomena; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D016687:Polydioxanone; D012785:Shoulder Joint / Q000601:surgery*; D013537:Sutures
chemical_list: D016687:Polydioxanone