Page 71 - Arthroscopic Knot Tying: An Instruction Manual

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Giant Knot (Fig. 37)

FIGURE 37. A-F. Giant knot.

The Giant knot(12 ) is a one-way self-locking ratchet knot. It is structurally similar to Nicky's knot. Nicky's
knot consists of three overhand half hitches, whereas the Giant knot has four overhand half hitches.
However, unlike Nicky's knot, this knot configuration locks by pulling on the loop strand once it is pushed
into place.

 The post limb should be one half the length of the loop limb.
 Make an overhand throw with the loop strand over the post (Fig. 37A ).
 Make a second overhand throw proximal (closer to the joint) to the first throw (Fig. 37B ).
 Make a third overhand throw distal (further from the joint) to the previous two throws (Fig. 37C ).
 Make a fourth overhand throw distal to the previous three throws (Fig. 37D ).
 Pull the post limb while using the knot pusher on the post limb to place the knot (Fig. 37E ).
 While holding the knot seated with the knot pusher and maintaining tension on the loop strand,
pull the loop limb forcibly to lock the knot (Fig. 37F ).

Although the initial description of this knot suggests that locking half hitches are unnecessary in the Giant
knot, our experience shows that locking with half hitches improves knot security (unpublished data).