Page 51 - Arthroscopic Knot Tying: An Instruction Manual

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Lieurance-Modified Roeder Knot (Fig. 26)

FIGURE 26. A-H. Lieurance-Modified Roeder knot.

The Lieurance-Modified Roeder knot (14 ,25 ) 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.

 The post limb should be one half the length of the loop limb.
 Throw an overhand loop around only the post strand (Fig. 26A ).
 Throw a second loop across both the post and loop limbs (Fig. 26B ).
 Throw a third loop across both the post and loop limbs (Fig. 26C ).
 Wrap the loop limb around the post only and bring it between the post and loop limbs (Fig. 26D ).
 Pass the tail of the loop limb over and through the initial loop made by the post and loop limbs (Fig.
26E ).
 Loosely tension the knot but do not pull on the loop strand or this will prematurely lock the knot
(Fig. 26F ).
 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. 26G ).
 Lock the knot with a series of three alternating half hitches with post switching (Fig. 26H ).
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.

The Lieurance-Modified Roeder was shown to resist clinical failure better than the Duncan loop,
Tennessee Slider, and Savoie-Modified Roeder but was worse than the Revo knot when testing with No. 2
Ethibond. When using PDS II No. 1 suture, the Lieurance-Modified Roeder performed the worst compared
to the Duncan loop, Revo knot, Tennessee Slider, and Savoie-Roeder. It is important to note that
statistical significance was not reached in either of the above trials (23 ).