title: The Nice knot as an improvement on current knot options: A mechanical analysis.
abstract: There is currently a wide range of suture knots used in rotator cuff repair. The purpose of this study was to compare a new type of self-locking sliding knot called the Nice knot to the self-locking and sliding Nicky's knot.
  
  
  
  Nice knots and Nicky's knots were tied and subjected to mechanical testing including a pure traction stress and a series of dynamic stresses. Both knots were tied using standard braided suture and reinforced braided suture. The responses to these stresses were measured in the amount of elongation of the knot, maximum effort needed for failure, stiffness of construct and dynamic stiffness.
  
  
  
  With both knots the standard suture had a lower amount of elongation during the dynamic tests than the reinforced braided suture. The reinforced braided suture showed superior results during maximal effort in the pure traction tests. An increased failure rate occurred due to elongation when a dynamic stress was applied to the reinforced suture in both knot types. During dynamic testing the Nice knot showed a decrease in the amount of elongation (P<0.001).
  
  
  
  The Nice knot provides a sliding locking knot option which can decrease the risk of elongation during dynamic stress.
  
  
  
  Basic Science Study, Biomechanical Study.
authors.affiliation: Saint-Grégoire Private Hospital Center, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Collin
authors.affiliation: Saint-Grégoire Private Hospital Center, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Laubster
authors.affiliation: Southern Oregon Orthopedics, Medford, Oregon, USA; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Denard
authors.affiliation: Saint-Grégoire Private Hospital Center, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France.
authors.forename: F A
authors.initials: FA
authors.lastname: Akuè
authors.affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, rue J.-D.-Maillard 3, 1217 Meyrin, Switzerland; Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland. Electronic address: alexandre.laedermann@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Lädermann
mesh_terms: D001696:Biomechanical Phenomena; D006801:Humans; D008422:Materials Testing; D019637:Orthopedic Procedures / Q000379:methods*; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries / Q000601:surgery; D013536:Suture Techniques; D013718:Tensile Strength
keywords: Arthroscopy; Biomechanical study; Ethibond(®); Mechanical testing; Nice knot; Nicky's knot; Rotator cuff repair; Shoulder surgery; Suture; Ultrabraid