Page 49 - Arthroscopic Knot Tying: An Instruction Manual

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Savoie-Modified Roeder Knot (Fig. 25)

FIGURE 25. A-I. Savoie-Modified Roeder knot.

The Savoie-Modified Roeder knot is a locking knot instead of a slipknot. It was included in this section so
it can be compared with other versions of the Roeder knot. Although a locking knot, the originators of this
knot recommend further reinforcing it with a series of three half hitches. This knot is similar to the Field
knot (11 ). When compared to the Field knot, the Savoie-Modified Roeder knot has an additional turn, and
the first loop is thrown in the opposite direction.

 The post limb should be one half the length of the loop limb.
 Throw an underhand loop around the post strand (Fig. 25A ).
 Throw a second loop around both the post and loop limbs. Be sure to leave a small “hole” in the
loop prior to throwing the second loop (Fig. 25B ).
 Throw a third loop around both the post and loop limbs (Fig. 25C ).
 Throw a fourth loop around both the post and loop limbs (Fig. 25D ).
 Wrap the loop limb around only the post and bring it away from the joint (Fig. 25E ).
 Pass the tail of the loop limb between the “hole” made in step C (Fig. 25F ).
 Loosely tension the knot but do not pull on the loop strand or this will prematurely lock the knot
(Fig. 25G ).
 While pulling on the post limb, push the knot into the joint with the knot pusher on the post strand.
 When the knot is seated, push down on the knot pusher to hold the knot in place and while
maintaining tension on the post strand, pull on the loop strand to lock the knot. This will prevent
the knot from loosening once tension is released from the strands (Fig. 25H ).
 Lock the knot with a series of three alternating half hitches with post switching (Fig. 25I ).
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.

Although statistically similar, when using No. 2 Ethibond, the Savoie-Modified Roeder was shown to resist
clinical failure better than the Duncan loop and the Tennessee Slider and worse than the Lieurance-
Modified Roeder and the Revo knot. When using PDS II No. 1 suture, the Savoie-Modified Roeder was
superior to the Tennessee Slider, Revo knot, Duncan loop, and Lieurance-Modified Roeder (23 ).