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dc.contributor.authorKim, SH-
dc.contributor.authorYoo, JC-
dc.contributor.authorWang, JH-
dc.contributor.authorChoi, KW-
dc.contributor.authorBae, TS-
dc.contributor.authorLee, CY-
dc.date.accessioned2024-01-21T05:12:09Z-
dc.date.available2024-01-21T05:12:09Z-
dc.date.created2021-09-03-
dc.date.issued2005-04-
dc.identifier.issn0749-8063-
dc.identifier.urihttps://pubs.kist.re.kr/handle/201004/136621-
dc.description.abstractPurpose: To evaluate the optimal number of additional half-hitches needed to achieve optimal knot-holding capacity (KHC) of lockable sliding knots. Type of Study: Mechanical testing study. Methods: Four configurations of arthroscopic knots (Duncan loop, Field knot, Giant knot, and SMC knot) were tested for their knot-holding capacity. For each knot configuration, 6 sequential knots were made including the initial sliding knot and an additional 5 knots by increasing the half-hitches 1 at a time. Each additional half-hitch was made as a reverse half-hitch with alternate posts. For each sequential knot configuration, 12 knots were made using No. 2 braided sutures. On the Servohydraulic materials testing system (Instron 8511; MTS, Minneapolis, MN), cyclic loading, load to clinical failure (3-mm displacement), load to ultimate failure, and mode of failure were measured. Results: Most of the initial loops without additional half-hitches showed dynamic failure with cyclic loading. However, after I additional half-hitch, all 3 (SMC, Field, and Giant) knots showed resistance to dynamic cyclic load. After 2 additional half-hitches, the Duncan loop was secured without slippage from the cyclic loading test. The mean displacement after the end of cyclic loading decreased with each additional half-hitch. In particular, the SMC and Giant knot reached plateau at 0.1-mm or less displacement after I additional half-hitch. The Field knot and Duncan loop needed 3 additional half-hitches. The SMC knot and Duncan loop needed I additional half-hitch to reach greater than 80 N at clinical failure, whereas the other 2 knots needed 2 additional half-hitches. For the load exceeding 100 N for clinical failure, the SMC knot required 3 additional half-hitches and the other 3 knots needed 4 additional half-hitches. Addition of more than 3 half-hitches did not increase the load to clinical failure in the SMC knot. However, load to clinical failure increased up to 4 additional half-hitches in the other 3 knots (P < .05). The load to ultimate failure reached plateau when 3 or more additional half-hitches were made for all knot configurations. As the number of additional half-hitches increased, the mode of failure switched from pure loop failure (slippage) to material failure (breakage). The Duncan loop showed poor loop security-even with 5 additional half-hitches, some failed by slippage (17%). On the other hand, after 3 additional half-hitches, the 3 other knots showed greater than 75% of failure by material breakage mode (SMC and Field 92%, Giant 75%). Conclusions: Even with its own locking mechanism, a lockable sliding knot alone does not withstand the initial dynamic cyclic load. For all tested variables, the SMC knot required a minimum of 2 additional half-hitches. All knots showed a near plateau in knot security with 3 or more additional half-hitches. The Duncan loop may need more than 3 additional half-hitches for optimal security. Clinical Relevance: The study shows that the knots tested needed at least 2 additional half-hitches, so this should become standard clinical practice.-
dc.languageEnglish-
dc.publisherW B SAUNDERS CO-ELSEVIER INC-
dc.subjectSLIP KNOT-
dc.subjectMONOFILAMENT SUTURE-
dc.subjectLOCKING MECHANISM-
dc.subjectLOOP SECURITY-
dc.titleArthroscopic sliding knot: How many additional half-hitches are really needed?-
dc.typeArticle-
dc.identifier.doi10.1016/j.arthro.2004.12.010-
dc.description.journalClass1-
dc.identifier.bibliographicCitationARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, v.21, no.4, pp.405 - 411-
dc.citation.titleARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY-
dc.citation.volume21-
dc.citation.number4-
dc.citation.startPage405-
dc.citation.endPage411-
dc.description.journalRegisteredClassscie-
dc.description.journalRegisteredClassscopus-
dc.identifier.wosid000228487600004-
dc.identifier.scopusid2-s2.0-15944392291-
dc.relation.journalWebOfScienceCategoryOrthopedics-
dc.relation.journalWebOfScienceCategorySport Sciences-
dc.relation.journalWebOfScienceCategorySurgery-
dc.relation.journalResearchAreaOrthopedics-
dc.relation.journalResearchAreaSport Sciences-
dc.relation.journalResearchAreaSurgery-
dc.type.docTypeArticle-
dc.subject.keywordPlusSLIP KNOT-
dc.subject.keywordPlusMONOFILAMENT SUTURE-
dc.subject.keywordPlusLOCKING MECHANISM-
dc.subject.keywordPlusLOOP SECURITY-
dc.subject.keywordAuthorarthroscopy-
dc.subject.keywordAuthorsliding knot-
dc.subject.keywordAuthorknot-holding capacity-
dc.subject.keywordAuthorhalf-hitch-
dc.subject.keywordAuthorknot security-
dc.subject.keywordAuthorloop security-
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KIST Article > 2005
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