Page 89 - Arthroscopic Knot Tying: An Instruction Manual

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Biomechanical Studies

Although no study has compared the biomechanical properties of all the arthroscopic knots in the
literature, there are several studies that have compared a limited number of arthroscopic knots (Table
2 ). One study compared the Overhand loop, the Duncan loop, the Roeder knot, and the Snyder knot using
monofilament and braided suture (26 ). The Roeder and Snyder knot had less displacement under cyclic
loading when compared to the Duncan loop and the Overhand loop. The Snyder knot had a higher load to
failure when compared to the Duncan loop, the Roeder knot, and the Overhand knot (Fig. 46 ). There was
a high likelihood that a knot tied with absorbable monofilament suture would fail by slippage whereas
knots tied with nonabsorbable braided suture were more likely to fail by suture rupture.

FIGURE 46. Load to Clinical Failure (26).
Elongation of arthroscopically tied knots. Am J Sports Med, 25(1): 113-7, 1997.

TABLE 2 Summary of Biomechanical Studies20 ,23 ,26 ,31
Ethibond Ethibond Maxon/Ticron Ethibond PDS II
RANK
Double- Revo knot Hand-tied Hand-tied Hand-tied
1 twist knot knot square knot square knot square knot
Tennessee Savoie
2 Slider SMC knot Snyder knot Revo knot Roeder

Snyder's Tennessee Lieurance Tennessee
3 knot Slider Duncan loop Roeder Slider

Savoie
4 Duncan loop Roeder knot Roeder Revo knot
Overhand Overhand Tennessee
5 knot knot Slider Duncan loop
Lieurance
6 Duncan loop Roeder
Rolla et al. 2002, Kim et al. 2001, Mishra et al. 1997, Lieurance et al. 2003

Note: Superior numbers refer to corresponding reference in reference section.