Page 63 - Arthroscopic Knot Tying: An Instruction Manual

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Ratchet Knots

Nicky's Knot (Fig. 33)

FIGURE 33. A-F. Nicky's knot.

Nicky's knot (9 ) is a one-way slipknot. It is a modification of the Taut line hitch (16 ,41 ).

 The post limb should be approximately half the length of the loop limb.
 Throw an overhand half hitch around the post (Fig. 33A ).
 Make a second overhand half hitch proximal (closer to the arthroscopic cannula) to the first throw
(Fig. 33B ).
 Bring the loop strand distal (closer to the ends of the suture) to the two loops and make a third
overhand half hitch (Fig. 33C ).
 Tension the knot by gently pulling on both limbs simultaneously (Fig. 33D ).
 Pull on the post strand while pushing the knot with the knot pusher on the post strand (Fig. 33E ).
 Lock the knot with a series of three alternating half hitches with post switching (Fig. 33F ).
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.