Cyclic Load and Failure Behavior of Arthroscopic Knots and High Strength Sutures

Optimization of the Racking Hitch Knot: How Many Half Hitches and Which Suture Material Provide the Greatest Security?

“…1 Numerous authors have analyzed the effect of suture choice on knot performance. Although there are no universal conclusions regarding the suture with the best repair characteristics, braided polyester sutures often have shown higher load to failure than alternative choices [2,9,10]. Abbi et al [1] reported that knots tied with FiberWire 1 had the highest load to failure values, averaging 275.97 N. Swan et al [11] also looked at the effect of suture type on load to failure using Force Fiber TM , FiberWire 1 , and Ethibond Excel TM .…”

“…However, little data exist to support the use the racking hitch knot to guide decision making regarding how to back up the knot or to explain the effect of suture material on security and strength. Questions/purposes The objectives of our study were (1) to identify the optimal number of half hitches necessary to maintain knot security for a single knot; (2) to evaluate if a difference exists in the relative behavior of racking hitch knots when tied using different suture materials; and (3) to define the biomechanical differences between the racking hitch and two other knot configurations commonly used in shoulder surgery (Weston and square knots). Methods Using an Instron device we tested the effect of adding supplemental half hitches (from one to four) to the racking hitch.…”

Early anchor displacement after arthroscopic rotator cuff repair

“…The biomechanical performance and the load to failure strength of the reconstruction depends greatly on the arthroscopic knot. The performance of different arthroscopic knots was investigated by Barber et al [10]. They found that the SMC knot-used in our series-had the second highest load to fail, while it was the least likely to slip.…”

“…These complications can lead to structural failure of the reconstruction and to severe damage of the joint [11]. The fixation of the anchors and the stability of the repair were investigated in several bio-mechanical studies [9,10,12]; however, much fewer in vivo results have been published [11,13]. Also, the investigations are mostly focused on the healing at the tendon-bone interface [3][4][5][6][14][15][16], and less attention is paid to the anchor-bone interface [9,11,17].…”

“…The need to achieve the strongest possible cuff fixation necessitated the development of novel arthroscopic suture anchors and high-strength sutures. Though the performance of these devices is convincing, new anchor designs continue to appear [9,10], and as a consequence new complications (i.e., anchor loosening, displacement, eyelet breakage, etc.). These complications can lead to structural failure of the reconstruction and to severe damage of the joint [11].…”