Nicky's knot--a new slip knot for arthroscopic surgery

DeBeer, JF; vanRooyen, K; Boezaart, AP

doi:10.1016/s0749-8063(98)70133-1

Cited by 69 publications

(29 citation statements)

References 1 publication

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“…Various arthroscopic sliding knots have been used in arthroscopic surgery [1][2][3][4][5][6][7][8][9][10], but these knots are seldom used by themselves, as they are usually supported by multiple half-hitches to enhance knot security [11,12].…”

Section: Introductionmentioning

confidence: 99%

Optimal configuration of arthroscopic sliding knots backed up with multiple half-hitches

Lee

Kang

et al. 2008

Knee Surg Sports Traumatol Arthr

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The purpose of this biomechanical study was to determine optimized configuration of additional half-hitches placed after various arthroscopic sliding knots. Four commonly used arthroscopic sliding knots, namely, the Duncan loop, the SMC, Weston, and SP knot, were included in this study. All knots were tied with a single-hole knot pusher using a knot-tying simulator. After tying a sliding knot, it was backed up with zero to four additional reverse half-hitches on alternating posts (RHAPs). The first half-hitch was either placed on the same post (conventional RHAP; c-RHAP) or on the loop limb of the sliding knot (switched RHAP; s-RHAP). Ten knots were tied in each configuration using No. 2 Ethibond or No. 1 PDSII sutures. Loop security (loop circumference at 5 N) and knot security (highest load to failure at a cross-head displacement of 3 mm) were measured. Knot configurations, number of RHAPs, or mode of placement of the first half-hitch did not make clinically significant effects on loop security for either suture type. Using No. 2 Ethibond sutures, SMC, SP, and Weston knots required at least three additional half-hitches before knot security plateaued. However, when the first half-hitch was switched to the loop limb of the sliding knot, only two additional half-hitches (2 s-RHAPs) were required to reach maximum knot security. Using No. 1 PDSII sutures, SMC knots needed one additional half-hitch to reach maximum knot security, whereas SP and Weston knots required two half-hitches. However, SMC, SP and Weston knots with switched first half-hitch only required one additional half-hitch (1 s-RHAP) to achieve maximum knot security. This study demonstrated that switching the post just after the sliding knot could save one half-hitch without compromising knot security. That means that sliding knots with 2 s-RHAPs for No. 2 Ethibond and 1 s-RHAPs for No. 1 PDSII achieved knot security comparable to that of sliding knots with 3 c-RHAPs and with 2 c-RHAPs, respectively. The results suggested that the optimized configuration for arthroscopic sliding knots required a secure sliding knot, such as, the SMC, SP, or Weston knots and 2 s-RHAPs when No. 2 Ethibond or No. 1 PDSII suture materials were used considering the unraveling tendency of No. 1 PDSII. Results of the current study may be helpful for establishing arthroscopic sliding knot-tying routines for best results in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Optimal configuration of arthroscopic sliding knots backed up with multiple half-hitches

Lee

Kang

et al. 2008

Knee Surg Sports Traumatol Arthr

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“…Twenty-three orthopaedic surgery residents at various stages of training were asked to learn to tie 10 different knot types: Duncan loop, 16 Revo knot, 10,13,16,20 Roeder knot, 16 French knot, 12 SMC knot, 9 Tennessee slider, 16 Nicky's knot, 3 Field knot, 5 giant knot, 6 and double-twist knot. 18 These represented the most commonly described knots in the literature.…”

Section: Methodsmentioning

confidence: 99%

Ease of tying arthroscopic knots

Baumgarten

Wright

2007

Journal of Shoulder and Elbow Surgery

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“…The spectrum of soft-tissue pathology in anterior instability includes glenoid lesions (glenoid labral tears/avulsions), capsular lesions (plastic deformation and tears) and humeral side lesions (humeral avulsion of glenohumeral ligament lesion, referred to as 'HAGL' lesions). New arthroscopic and mini-open techniques provide minimally invasive and reliable alternatives to the traditional open repairs of these lesions [3][4][5][6]. We present an overview of our surgical techniques for the management of soft-tissue lesions associated with anterior shoulder instability.…”

Section: Introductionmentioning

confidence: 99%

Management of Anterior Shoulder Instability without Bone Loss: Arthroscopic and Mini-Open Techniques

Bhatia

Beer

2011

Shoulder & Elbow

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Anterior shoulder instability is a complex problem and necessitates accurate pre-and intraoperative assessment of soft-tissue and bony pathology. Soft tissue pathology plays a major role in anterior instability without bone loss, and includes glenoid lesions (glenoid labral tears/avulsions), capsular lesions (plastic deformation and tears), and humeral side lesions (humeral avulsion of glenohumeral ligament lesion referred to as ''HAGL'' lesions). Glenoid labral tears and capsular lesions are adequately addressed with the ''labroplasty'' procedure. This involves a sequential capsulolabral shift using correctly oriented sutureanchors, to effectively reduce the capsular volume. In addition, technical maneuvers like the ''double-grasper shift'' and ''Noose maneuver'' are crucial to recreate a labral bumper effect at the glenoid edge. HAGL lesions may be difficult to detect, and use of the axillary-pouch portal (Bhatia portal) facilitates identification of the tear. A new mini-open subscapularis-sparing technique permits secure repair of the HAGL lesion without a subscapularis tenotomy or even a split. Postoperative rehabilitation is guided by intra-operative tensioning of the capsulolabral tissue.

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Nicky's knot--a new slip knot for arthroscopic surgery

Cited by 69 publications

References 1 publication

Optimal configuration of arthroscopic sliding knots backed up with multiple half-hitches

Optimal configuration of arthroscopic sliding knots backed up with multiple half-hitches

Ease of tying arthroscopic knots

Management of Anterior Shoulder Instability without Bone Loss: Arthroscopic and Mini-Open Techniques

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