Performance Comparison of a Pretied Suture Knot With Three Conventional Arthroscopic Knots

Rodes, Stephen A.; Favorito, Paul J.; Piccirillo, Justin; Spivey, James T.

doi:10.1016/j.arthro.2015.05.014

Cited by 8 publications

(15 citation statements)

References 27 publications

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“…Many widely cited articles arbitrarily define a cutoff of 3 mm of elongation to represent clinical failure. 6,9,10,13,14,16,18,19,21,22,[24][25][26][27][28]33,35,36 To remain consistent with other studies and because the tolerance for loss of tissue apposition with respect to healing is unclear, 3 mm of suture loop elongation, or suture breakage, defined clinical failure in this study. Given the possibility that healing potential requires less than 3 mm of gap formation, results were collected for failure defined at 2 mm of displacement.…”

Section: Discussionmentioning

confidence: 84%

“…Placement of large prominent knots adjacent to a joint surface is a described cause of chondral injury after shoulder labral repairs and knee meniscal repairs. 14 Foreign body reaction is also of concern and can be exacerbated with increasing amounts of suture material present. 7,8,11,14 The purpose of this study was to compare knot and loop characteristics of commonly used high-strength tapes and high-strength round sutures.…”

mentioning

confidence: 99%

“…14 Foreign body reaction is also of concern and can be exacerbated with increasing amounts of suture material present. 7,8,11,14 The purpose of this study was to compare knot and loop characteristics of commonly used high-strength tapes and high-strength round sutures. The authors hypothesized that the narrow tape sutures would demonstrate overall superior mechanical characteristics across all knot types to provide the best overall sutureknot construct.…”

mentioning

confidence: 99%

“…It has been implicated that suture or material-related failure results from a single extreme load, while biologic or tissue failure occurs via cyclic loading. 9 , 13 , 14 , 15 , 16 Numerous studies have affirmed the importance of knot and loop security to create an effective knotted suture loop construct. 6 , 7 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 Loop security refers to the ability to maintain a fixed suture loop while tying the knot.…”

mentioning

confidence: 99%

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Mechanical Comparison of High-Strength Tape Suture Versus High-Strength Round Suture

Ensminger

McIff

Vopat

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To compare knot and loop characteristics of commonly used high-strength tapes and high-strength round sutures. Methods: Twenty tied 30-mm loops were prepared for using suture-knot combinations of 4 common arthroscopic knots or a hand-tied surgeon's knot and 7 sutures. Two tapes (BroadBand, SutureTape) and three no. 2 sutures (MaxBraid, FiberWire, DynaCord) were compared. Two additional larger tape sutures (FiberTape, PermaTape) not commonly tied arthroscopically were included in the hand-tied group. Each suture-knot combination was evaluated for loop integrity (single load to a specified elongation), knot security (plastic loop deformation with cyclic testing), loop security, and knot volume. Data were compared using analysis of variance followed by Tukey-Kramer post hoc tests.Results: BroadBand and SutureTape demonstrated superior loop integrity compared to most no. 2 suture-knot combinations. FiberTape (430.48 AE 89.00 N) and PermaTape (545.16 AE 95.09 N) required significantly greater force to undergo 3 mm of displacement than all other hand-tied sutures (P < .001). All suture-knot configurations demonstrated significant plastic deformation (cyclic elongation) over 1000 cycles (P < 0.001). DynaCord displayed the best loop security except when paired with the Duncan loop. Overall, BroadBand and SutureTape had lower knot volumes compared to all other sutures. Conclusion: This study exhibits the ability of narrow tape sutures to provide reliable tissue apposition and fixation in multiple suture-knot configurations, while decreasing the potential adverse effects accompanying knot prominence. Generally, BroadBand and SutureTape demonstrated an ideal balance of mechanical characteristics to achieve the optimal suture-knot construct among those tested. Dynacord displayed superior loop security and performed best among round sutures. PermaTape and FiberTape showed greater loop integrity, albeit to the detriment of loop security and knot volume. Clinical Relevance: When securing a rotator cuff repair construct with a knot, one should have a basic understanding of the mechanical properties of the suture and knot being used to provide the best possible repair. This study will provide information about the mechanical characteristics of commonly used high-strength tape suture knots and loops to help determine what knot type may provide the best overall construct.

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Section: Discussionmentioning

confidence: 84%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Mechanical Comparison of High-Strength Tape Suture Versus High-Strength Round Suture

Ensminger

McIff

Vopat

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Equally important, however, is the surgical technique and knot selection for arthroscopic suturing. 2 , 3 , 4 …”

mentioning

confidence: 99%

The West Point Knot: A Sliding-Locking Arthroscopic Knot

Wolfe

Pickett

Blarcum

et al. 2018

Arthroscopy Techniques

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Despite the advent of sutureless technology, knot tying remains an important skill for any arthroscopist. When one is choosing which knot to tie, there are a variety of options, with each possessing its own inherent strengths and weaknesses. The West Point knot is a sliding-locking arthroscopic knot that is relatively easy to learn and has excellent knot security. This article details the appropriate manner in which to tie this knot.

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