title: Pretzel knot compared with standard suture knots.
abstract: OBJECTIVE
  Aim of this paper is to compare the biomechanical properties of the Pretzel knot with the selected arthroscopic knots and to test the mechanical safety of this knot. The hypothesis was that the Pretzel knot may have equal or better mechanical properties than the arthroscopic knots tested in this study.
  
  
  METHODS
  SMC, Giant, Dines, Nicky's, Tennessee Slider knots were chosen for comparison. Original and backed configuration of knots were prepared with no. 2 braided polyester sutures. Cyclic loading and load to failure tests were performed. Parameters tested were loop security, maximum elongation and load at failure. Number of steps needed for preparation of each knot was also recorded. One-way ANOVA for repeated measures was performed for all knots.
  
  
  RESULTS
  Steps needed for preparation were 2 for Pretzel and Tennessee Slider, 3 for Nicky's, SMC and Dines and 4 for Giant. The Pretzel knot in original configuration had significantly better loop security compared to SMC, Dines, Nicky's and Tennessee knots (P = 0.01). Loads at failure were not significantly different between knots in their original configurations. Giant and Dines knots showed better maximum elongations in cyclic loading (P = 0.0059) and load to failure tests (P = 0.0001). Backing up the knots with 3-RHAPs eliminated most of these significant differences.
  
  
  CONCLUSIONS
  Clinically, simplicity and safety are two important components in arthroscopic knot tying. Despite its simple configuration, Pretzel knot has some similar and increased mechanical properties compared to the tested knots that are widely used.
authors.affiliation: Department of Orthopedics and Traumatology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karahan
authors.forename: Umut
authors.initials: U
authors.lastname: Akgun
authors.forename: Ahu
authors.initials: A
authors.lastname: Turkoglu
authors.forename: Rustu
authors.initials: R
authors.lastname: Nuran
authors.forename: Filiz
authors.initials: F
authors.lastname: Ates
authors.forename: Can A
authors.initials: CA
authors.lastname: Yücesoy
mesh_terms: D000704:Analysis of Variance; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D006801:Humans; D008422:Materials Testing; D011093:Polyethylene Terephthalates; D013536:Suture Techniques; D013537:Sutures; D016474:Weight-Bearing
chemical_list: C014534:Ethibond; D011093:Polyethylene Terephthalates