Beyond the Square Knot: A Novel Knotting Technique for Surgical Use by Chunfeng Zhao, Chung-Chen Hsu, Tamami Moriya, Andrew R. Thoreson, Steven S. Cha,

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Presentation transcript:

Beyond the Square Knot: A Novel Knotting Technique for Surgical Use by Chunfeng Zhao, Chung-Chen Hsu, Tamami Moriya, Andrew R. Thoreson, Steven S. Cha, Steven L. Moran, Kai-Nan An, and Peter C. Amadio J Bone Joint Surg Am Volume 95(11): June 5, 2013 ©2013 by The Journal of Bone and Joint Surgery, Inc.

The top panel shows an apparatus (A) for making a suture loop. Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.

The six tested knot configurations: a 3-throw square knot (A), a 4-throw square knot (B), a 1- throw surgeon’s knot with a 2-throw square knot (C), a 1-throw surgeon’s knot with a 3-throw square knot (D), a 5-throw square knot (E), and a TSOL knot (F). Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.

Testing of a tendon repair. Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.

Failure strength (Fig. 4-A) and stiffness (Fig. 4-B) with three different suture materials (braided polyblend [FW], polydioxanone [PDS], and polyester [Ethibond]) and three different knot configurations (8-throw square knot [Intact], TSOL knot, and 4-throw... Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.

Failure strength (left y axis) and stiffness (right y axis) with six different knot configurations. Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.

The failure strength (left y axis) and stiffness (right y axis) for tendon repairs with the TSOL knot were significantly higher than those for repairs with the 4-throw square knot. Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.

TSOL knot technique. Chunfeng Zhao et al. J Bone Joint Surg Am 2013;95: ©2013 by The Journal of Bone and Joint Surgery, Inc.