Purpose
To compare the biomechanical, time, and profile characteristics of a new sliding locking
knot termed the slippage-proof knot (SPK) and a modified slippage-proof knot (MSPK)
with those of traditional arthroscopic knots.
Methods
We evaluated the Samsung Medical Center (SMC) knot, Revo knot, SPK, and MSPK (an SPK
with a single added half-hitch) tied with high-strength suture, with 11 trials of
each cycled 1,000 times between 10 and 45 N and then loaded to failure. Total displacement
during cyclical testing, maximal load to failure, and mode of failure were recorded
for each knot. We also measured the dimensions of the knots and the time required
to tie each knot.
Results
On load-to-failure testing, no difference in strength was found between the SMC and
Revo knots (P = .082). The Revo knot and MSPK were also of equivalent strength (P = .183), and the SMC knot was 11% stronger than the MSPK (P = .017). All 3 of these knots were stronger than the SPK. On cyclical testing, the
SMC knot, Revo knot, and MSPK allowed equivalent total displacement and allowed statistically
less total displacement than the SPK. All SMC knots, Revo knots, and MSPKs failed
by suture breakage, whereas the SPKs all slipped at failure. We found that the SPKs
and MSPKs are tied more quickly than traditional knots. The SPK and MSPK dimensions
are wider yet shorter than those of the other knots in the study.
Conclusions
Our results indicate that the MSPK has biomechanical properties comparable to the
SMC and Revo knots despite only requiring 1 added half-hitch, whereas the SPK was
found to be significantly inferior to the other knots tested. We found that the slippage-proof
knots (SPK and MSPK) were tied more quickly and have shorter, wider profiles than
traditional knots.
Clinical Relevance
The MSPK has knot security comparable to the SMC and Revo knots while requiring only
1 added half-hitch, and it may be most beneficial in cases in which a large number
of knots will be tied because the fewer required half-hitches reduces the surgical
time without reducing its biomechanical properties.
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Article Info
Publication History
Accepted:
April 16,
2013
Received:
June 21,
2012
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- ErratumArthroscopyVol. 29Issue 8
- “Biomechanical Performance of Traditional Arthroscopic Knots Versus Slippage-Proof Knots”: A Word From the Developer of the Slippage-Proof (SP) KnotArthroscopyVol. 29Issue 10
- PreviewAs the developer of the slippage-proof (SP) knot,1 I read with great interest the article “Biomechanical Performance of Traditional Arthroscopic Knots Versus Slippage-Proof Knots” by Clark et al.2 First, I appreciate the authors for their use of the SP knot among various arthroscopic knots and congratulate their success both in clinical practice and in this scientific study with the SP knot. It is a great pleasure and honor for me that the SP knot receives recognition and has come to be used by many arthroscopic surgeons, and thus I could contribute a little to arthroscopic knowledge in the world.
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