Abstract
We sought to determine which simple sliding knot configurations would have adequate strength for rotator cuff repair. Four knot configurations were tied with both No. 1 polydioxanone suture and No. 2 Ethibond suture (Ethicon, Somerville, NJ) using 3 different tying techniques: hand-tie, standard knot pusher, and cannulated double-diameter knot pusher. The knots were then tested to failure on a materials testing system. The weakest standard knot configuration was S =S =S =S. The other 3 knot configurations (S//S//S//S, SxSxSxS, and S//xS//xS//xS) generally failed in the 35 to 50 N range. Ultimate strength in this range can be shown to be adequate to withstand, without suture failure, a maximal contraction of a repaired rotator cuff tear within the rotator crescent, assuming certain conditions are met (suture anchors placed 1 cm apart, 2 sutures per anchor). More complex knots are not necessary for adequate knot security. However, the same configuration with only 1 suture per anchor will not be strong enough because the suture will fail under maximum physiological load. This study shows that we can predict the adequacy of a given knot configuration under maximum physiological loading conditions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 202-207 |
| Number of pages | 6 |
| Journal | Arthroscopy |
| Volume | 16 |
| Issue number | 2 |
| State | Published - Mar 2000 |
| Externally published | Yes |
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Keywords
- Biomechanics
- Knot tying
- Rotator cuff tears
- Shoulder arthroscopy
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
Cite this
Knot security in simple sliding knots and its relationship to rotator cuff repair : How secure must the knot be? / Burkhart, Stephen S.; Wirth, Michael A.; Simonich, Matthew; Salem, Daniel; Lanctot, Dan; Athanasiou, Kyriacos.
In: Arthroscopy, Vol. 16, No. 2, 03.2000, p. 202-207.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Knot security in simple sliding knots and its relationship to rotator cuff repair
T2 - How secure must the knot be?
AU - Burkhart, Stephen S.
AU - Wirth, Michael A.
AU - Simonich, Matthew
AU - Salem, Daniel
AU - Lanctot, Dan
AU - Athanasiou, Kyriacos
PY - 2000/3
Y1 - 2000/3
N2 - We sought to determine which simple sliding knot configurations would have adequate strength for rotator cuff repair. Four knot configurations were tied with both No. 1 polydioxanone suture and No. 2 Ethibond suture (Ethicon, Somerville, NJ) using 3 different tying techniques: hand-tie, standard knot pusher, and cannulated double-diameter knot pusher. The knots were then tested to failure on a materials testing system. The weakest standard knot configuration was S =S =S =S. The other 3 knot configurations (S//S//S//S, SxSxSxS, and S//xS//xS//xS) generally failed in the 35 to 50 N range. Ultimate strength in this range can be shown to be adequate to withstand, without suture failure, a maximal contraction of a repaired rotator cuff tear within the rotator crescent, assuming certain conditions are met (suture anchors placed 1 cm apart, 2 sutures per anchor). More complex knots are not necessary for adequate knot security. However, the same configuration with only 1 suture per anchor will not be strong enough because the suture will fail under maximum physiological load. This study shows that we can predict the adequacy of a given knot configuration under maximum physiological loading conditions.
AB - We sought to determine which simple sliding knot configurations would have adequate strength for rotator cuff repair. Four knot configurations were tied with both No. 1 polydioxanone suture and No. 2 Ethibond suture (Ethicon, Somerville, NJ) using 3 different tying techniques: hand-tie, standard knot pusher, and cannulated double-diameter knot pusher. The knots were then tested to failure on a materials testing system. The weakest standard knot configuration was S =S =S =S. The other 3 knot configurations (S//S//S//S, SxSxSxS, and S//xS//xS//xS) generally failed in the 35 to 50 N range. Ultimate strength in this range can be shown to be adequate to withstand, without suture failure, a maximal contraction of a repaired rotator cuff tear within the rotator crescent, assuming certain conditions are met (suture anchors placed 1 cm apart, 2 sutures per anchor). More complex knots are not necessary for adequate knot security. However, the same configuration with only 1 suture per anchor will not be strong enough because the suture will fail under maximum physiological load. This study shows that we can predict the adequacy of a given knot configuration under maximum physiological loading conditions.
KW - Biomechanics
KW - Knot tying
KW - Rotator cuff tears
KW - Shoulder arthroscopy
UR - http://www.scopus.com/inward/record.url?scp=0034049513&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034049513&partnerID=8YFLogxK
M3 - Article
VL - 16
SP - 202
EP - 207
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
SN - 0749-8063
IS - 2
ER -