鏡視下糸結び法には half hitch の追加が不可欠である

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Background: The purpose of this study was to investigate the mechanical characteristics of arthroscopic knots, focusing on the effect of tying additional reversed half hitches on alternating posts (RHAPs) during knot tying. Methods: Three sliding arthroscopic knots (Duncan loop, Tennessee slider, SMC knot) and three non-sliding arthroscopic knots (Rotator cuff knot, Revo knot, Surgeon's knot) were tied with No. 2 FiberWire (Arthrex, Naples, FL) between 2 rods. Tensile testing for failure was performed using a materials testing machine, 10 times in each knot, and then ultimate load and failure mode were recorded. When a suture slipping in the knot was seen at least once in 10 tests, a half hitch was added followed by tensile testing again until suture breakage occurred in all 10 tests. Results: Average ultimate load without additional half hitch was 36N in Duncan loop, 30N in Tennessee slider, 46N in SMC knot, 241N in Rotator cuff knot, 215N in Revo knot, 290N in Surgeon's knot. For all 3 sliding knots, suture slipping occurred in all 10 tests. Ultimate loads of sliding knots were significantly less than that of non-sliding knots (p<0.01). Additional 4 half hitches for all sliding knots and additional 1 half hitch for Rotator cuff knot and Revo knot were necessary to avoid suture slipping in the knot. Final failure load with additional half hitches were not significantly different among all 6 styles of knot tying. Conclusion: For arthroscopic surgery, additional half hitch is necessary to improve initial strength of the knot tying, specifically in sliding knots.

鏡視下糸結び法には half hitch の追加が不可欠である

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