O3381 IS IT TIME TO CHANGE OUR KNOTTING TECHNIQUE?

Abstract

Aim: A comparative in vitro study to identify which knot conþguration is the strongest and most secure in orthopaedic surgery. Background: It has been proven that monoþlament sutures are less damaging to soft tissues than multiþlament (braided) ones. However braided sutures are still popular with orthopaedic surgeons. It is thought that this is due to the knot-holding properties of braided materials. Methods: Four commonly used surgical knots were tied on a novel knot-testing rig by the same operator. They were subjected to a series of static (n=300) and pulsatile (n=380) forces in different environments, to simulate anticipated physiological demands. These tests were performed on both absorbable and non-absorbable sutures in both mono-þlament and braided form. Results: These 680 knotting tests show that the surgeonsñ knot is not always the best option in every situation and that surgeons should have a range of knots in their arsenal. Conclusions: This study has shown that monoþlament sutures can be as strong and reliable as braided materials if tied with appropriate knots. Therefore, by using a variety of knotting techniques, a surgeon may rely more heavily on monoþlament sutures, thereby reducing the soft-tissue trauma and infection risk that braided sutures involve.