Page 94 - Arthroscopic Knot Tying: An Instruction Manual

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The first study comparing arthroscopic knots to hand-tied knots revealed that hand-tied knots had less
displacement and higher loads to failure than did arthroscopically tied knots (24 ). However, more recent
studies suggest that arthroscopic knots may be equivalent in tensile properties when compared with hand-
tied knots. Although one recent study showed that although knots tied by hand with Maxon (US Surgical
Corporation, Norwalk, CT) monofilament suture had less loop elongation and higher ultimate load to
failure when compared to arthroscopic knots, the mechanical properties of braided, nonabsorbable suture
were not statistically different when comparing hand tied versus arthroscopic knots (26 ). Loutzenheiser
et al. (25 ) confirmed these findings when they showed that there was no difference between hand-tied
and arthroscopic knots using braided suture. Lieurance et al. (23 ) showed that there was no difference
found between hand-tied knots and arthroscopic knots in both absorbable monofilament and
nonabsorbable braided suture. A recent study showed: 1) hand-tied knots have higher initial displacement
when compared with arthroscopic knots, and 2) modified Revo knots are as durable as hand-tied square
knots in regard to loosening under cyclic loading (17 ).