Page 37 - Arthroscopic Knot Tying: An Instruction Manual

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Revo Knot (Fig. 19)

FIGURE 19. A-K. Revo knot.

FIGURE 19. (Continued)

The current Revo knot (S = SxS//xS//xS) is a modification of the Original Revo knot (20 ,23 ,27 ,34 ). It
consists of two identical half hitches followed by a reversed half hitch on the same post. The post is
switched and a reversed half hitch is thrown. The post is again switched and a reversed half hitch is
thrown. This is the only version of the Revo knot that uses the three reversed half hitches on alternating
posts construct that has been shown to have the highest load to failure among half hitch configurations
(25 ).

 Throw an underhand loop around the post (Fig. 19A ).
 Advance the loop with the knot pusher on the loop limb until the first half hitch is seated (Fig.
19B ).
 Withdraw the knot pusher while maintaining tension on the post limb.
 Throw another underhand loop around the same post (Fig. 19C ).
 Pull the loop into the joint and seat the knot with the knot pusher. Once the two hitches are
seated, past-point to cinch the knot down (Figs. 19D, E ).
 Throw an overhand half hitch around the post and advance with the knot pusher on the loop (Fig.
19F ).
 Further tension by past pointing and apply tension on both limbs while holding the pusher in
position beyond the knot (Fig. 19G ).
 Switch posts and throw an underhand loop around the new post (Fig. 19H ).
 Pull the loop into the joint, seat the knot with the knot pusher, and past point to cinch the knot
down (Fig. 19I ).
 Switch posts and throw an overhand loop around the new post (Fig. 19J ).
 Pull the loop into the joint, seat the knot with the knot pusher, and past point to cinch the knot
down (Fig. 19K ).

The current Revo knot, when tied with No. 2 Ethibond, has been shown to have higher loads to failure
than the Tennessee Slider, the SMC knot, the Duncan loop and the Overhand Throw (20 ,23 ) but has
similar biomechanical properties with the Lieurance-Modified Roeder and the Savoie-Modified Roeder.
When using PDS suture, the Revo knot has been shown to be similar to the Lieurance-Modified Roeder, the
Duncan loop, the Tennessee Slider, and the Savoie-Modified Roeder (23 ).