Initial loop and knot security of arthroscopic knots using high-strength sutures.
OBJECTIVE
There are many options for arthroscopic knots including the type of knot and suture material used. The current investigation evaluated knot properties using 3 high-strength suture materials tied in 5 common arthroscopic knot configurations.


METHODS
Four arthroscopic sliding knots including the Roeder, Weston, SMC, and Tennessee Slider and an arthroscopic nonsliding Surgeon's knot were evaluated. Each knot was tied with each of 3 No. 2 polyblended suture types (Fiberwire [Arthrex, Naples, FL], Ultrabraid [Smith & Nephew, Andover, MA], and Orthocord [Mitek, Raynham, MA]). Each configuration was tied 8 times, for a total of 120 samples. Loop security and knot security were then evaluated by using a previously described protocol comparing the different knot types and suture material.


RESULTS
With respect to loop security, Orthocord performed better than the other tested suture materials, producing on average smaller knot loops. For the nonsliding Surgeon's knot, there was no difference in loop security observed between suture types. For the Roeder knot, Fiberwire had superior knot security compared with Ultrabraid and Orthocord (P < .001). For the Weston knot, Ultrabraid showed superior knot security compared with Orthocord (P < .02). Knot security for the Tenessee slider knot was better for both Fiberwire and Ultrabraid compared with Orthocord (P < .001, respectively). Similar results were seen with the SMC knot, with Fiberwire and Ultrabraid outperforming Orthocord (P < .001, respectively). The nonsliding Surgeon's knot had significantly lower mean loads to failure compared with arthroscopic sliding knots for each tested suture material (P < .02 for all comparisons).


CONCLUSIONS
Loop security and knot security varied depending on the type of knot tied and suture material used. Arthroscopic sliding knots performed better than the nonsliding Surgeon's knot.


CONCLUSIONS
Surgeons should try to use sliding knots instead of Surgeon's knots when using polyblend suture material. Differences between the brands in this suture category will change the characteristics of the knots thrown and may ultimately affect tissue fixation.
Department of Orthopaedic Surgery, Sports Medicine Service, New York University Hospital For Joint Diseases, New York, New York 10003, USA.
Mehul R
MR
Shah
Eric J
EJ
Strauss
Kevin
K
Kaplan
Laith
L
Jazrawi
Jeffrey
J
Rosen
D001182:Arthroscopy; D020099:Coated Materials, Biocompatible; D006801:Humans; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength
D020099:Coated Materials, Biocompatible