Page 81 - Arthroscopic Knot Tying: An Instruction Manual

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Cross Square Knot (Fig. 42)

FIGURE 42. A-G. Cross Square knot.

The Cross Square knot is a modified square knot. One must take care to prevent the knot from locking
while advancing the knot down the post.

 The post limb should be one half the length of the loop limb.
 Tie a granny knot but do not tension between throws (Figs. 42A, B ).
 Cross the second loop of the granny knot (loop farthest from joint) over on itself (Fig. 42C ).
 Pass the tail end of the loop under and through the middle loop (Fig. 42D ).
 Pass the tail end of the loop over and through the loop farthest from the joint (Fig. 42E ).
 Tension the knot by predominantly pulling on the post strand and gently pulling on the loop strand
at the same time. Avoid pulling too forcibly on the loop strand or the knot will lock prematurely.
 Advance the knot by pulling on the post limb while pushing the knot with the knot pusher on the
post strand (Fig. 42F ).
 Tension both strands while holding the knot in place with the knot pusher to cinch the knot down
(Fig. 42G ).

The Cross Square knot was determined to be an unreliable knot with all ligatures tested (33 ).