Page 41 - Arthroscopic Knot Tying: An Instruction Manual

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Fishing Duncan Loop (Fig. 21)

FIGURE 21. A-F. Fishing Duncan loop.

 Make the post limb half as long as the loop limb.
 Grasp the sutures between the thumb and index finger of the non-dominant hand and pass the loop
limb across both the loop and the post making a large circle with the loop strand (Fig. 21A ).
 Wrap the loop around the combined post and loop limbs held in the nondominant hand and bring
the tail of the loop limb through the circle made by the loop strand (Fig. 21B ).
 Make an additional five turns around the combined post and the loop limbs in the same fashion
traveling away from the joint. After the final turn, the tail of the loop limb should pass through the
large circle created by the loop strand (Fig. 21C ).
 Pull on the loop limb and post limb simultaneously to tighten the knot (Fig. 21D ).
 Advance the knot by simultaneously pulling on the post limb and pushing the knot down with the
knot pusher on the post limb (Fig. 21E ).
 Lock the knot with a series of three alternating half hitches with post switching (Fig. 21F ).
o Throw an underhand loop on the original post. Tension with the knot pusher.
o Switch posts.
o Throw an overhand loop over the new post. Tension with the knot pusher.
o Switch posts.
o Throw an underhand loop on the original post again. Tension with the knot pusher.