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Basic Science Research
 | Cyclic Testing of Arthroscopic Knot Security.
Presented at the 2003 annual meeting of the Arthroscopy Association of North
America and published in the journal Arthroscopy in 2004, this investigation
evaluated the holding power of several arthroscopic knots. Surgeons have long
used knots to secure soft tissue repairs. The knots hold the tissue apposed
until tissue healing occurs. Some tissues (such as skin) heal within days,
whereas others (such as tendons) take many weeks or even months. During this
time, the knot is subjected to hundreds and possibly even thousands of cyclic
loads with daily use of the repaired joint or extremity. The standard knot of
open surgery for secure repairs that can withstand such prolonged and
repetitive loading is the hand-tied surgical square knot. Recently, minimally
invasive arthroscopic techniques have evolved to the point of allowing
surgeons to repair soft tissue without open surgery. However, because tying
square knots is not feasible with arthroscopic techniques, many different
arthroscopic knots have been introduced into current use. Prior to this investigation
at TASMI, none of these knots had been tested under hundreds of
cyclic loads to see if they hold up to these stresses as well as traditional
square knots. This investigation revealed that one of the three different
types of arthroscopic knots tested was just as secure as the traditional
square knot hand-tied using open surgical means. However the other two
arthroscopic knots proved to be inferior to the square knot. This was the
first published study of its kind, as each knot was tested for more than 2000
cycles! |
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