Page 13 - Arthroscopic Knot Tying: An Instruction Manual

P.6
Knot Types

The ideal arthroscopic knot should slide easily into the joint but not slip once cinched into position. There
are a variety of knot types commonly used. These include nonsliding knots, sliding knots, and locking
knots.

Nonsliding knots are knots that do not slide though the tissues being apposed. They include the square
knot and knots consisting of a series of half hitches like the Revo knot (34 ). Although the square knot fails
at higher loads than do series of half hitches in hand-tied knots (38 ), the square knot is not commonly
used arthroscopically. The square knot is a flat knot in which both strands enter and leave the knot
parallel to each other (Fig. 6 ). In order to tie a square knot, symmetric tension must be simultaneously
applied to each limb, which is difficult to do arthroscopically. If asymmetric tension is applied to one of
the limbs, the knot converts to two nonidentical half hitches. Thus, most arthroscopic surgeons prefer
using a series of half hitches.