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ARTHROSCOPIC KNOTS : THE TAUTLINE HITCH COMES OUT ON TOP



Abstract

Aim of Study To assess the efficacy of commonly used sutures materials with commonly described arthroscopic knotting techniques in as close a physiological pattern as possible.

Methods The investigation was carried out in three phases. Initially the ultimate strength of the suture material was tested. Materials compared were 1PDS, 2 Ethibond, 1 Panacryl The suture was then tested to failure by two surgeons comparing five different knotting techniques. Knots tested were Tennessee slider, Duncan loop, SMC, Tautline hitch, and Surgeons knot. Finally the test was repeated after soaking the suture with normal saline.

Results As expected, 2 ethibond has a higher ultimate strength than either 1 PDS or 1 Panacryl. The Tautline hitch and Surgeon’s knot had a significantly lower slippage rate when compared to the other knotting techniques. (P value < 0.002). The Tennessee slider, Duncan Loop and SMC knots slipped in > 50% of experiments. No difference was observed when the suture material had been soaked in normal saline. The number of half hitches required to provide maximum knot holding capacity was 3, confirming previous experimental findings by other investigators.

Conclusions Tautline hitch is recommended for use with all suture materials due to low slippage rates, ease of tying, ease of sliding and overall high knot strength.

The abstracts were prepared by Secretary Mr K Trimble.