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The Wiese Knot: A Sliding-Locking Arthroscopic Knot.

ABSTRACT: Despite recent advances in knotless suture devices for arthroscopic surgical procedures, arthroscopic knot tying remains a necessary skill for the arthroscopic surgeon. Successful completion of arthroscopic knot tying relies on a thorough understanding of the chosen technique, proper suture management, adequate knot tensioning and securement, and the ability to reproducibly create the knot. We introduce a technique that serves as both a sliding and locking knot while being simple to master and reproducible to perform.

SUBMITTER: Parada SA

PROVIDER: S-EPMC5368054 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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The Wiese Knot: A Sliding-Locking Arthroscopic Knot.

Parada Stephen A SA Shaw K Aaron KA Eichinger Josef K JK Boykin Nathan T NT Gloystein David M DM Ledford Cheryl L CL Arrington Edward D ED Wiese Paul T PT

Arthroscopy techniques 20170102 1

Despite recent advances in knotless suture devices for arthroscopic surgical procedures, arthroscopic knot tying remains a necessary skill for the arthroscopic surgeon. Successful completion of arthroscopic knot tying relies on a thorough understanding of the chosen technique, proper suture management, adequate knot tensioning and securement, and the ability to reproducibly create the knot. We introduce a technique that serves as both a sliding and locking knot while being simple to master and r ...[more]

PMID: 28373935

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The West Point Knot: A Sliding-Locking Arthroscopic Knot.

Project description:Despite the advent of sutureless technology, knot tying remains an important skill for any arthroscopist. When one is choosing which knot to tie, there are a variety of options, with each possessing its own inherent strengths and weaknesses. The West Point knot is a sliding-locking arthroscopic knot that is relatively easy to learn and has excellent knot security. This article details the appropriate manner in which to tie this knot.

| S-EPMC6073083 | biostudies-other

Loop and knot security of a novel arthroscopic sliding-locking knot using high-strength sutures.

Project description:ObjectiveWe evaluated the loop and knot security of a novel arthroscopic knot, the Wiese knot, using different types of sutures.MethodsThe Wiese knot was tied using four different brands of braided sutures (Ethibond, Orthocord, FiberWire, and UltraBraid) with and without a series of three reversing half-hitches (RHAPs) and tested for loop and knot security.ResultsOrthocord provided the greatest amount of loop security. FiberWire delivered the highest knot security. UltraBraid had the greatest ultimate force. Three half-hitches increased the maximal load to clinical failure.ConclusionThe biomechanical characteristics of the Wiese knot are affected by suture material qualities.

| S-EPMC6138853 | biostudies-literature

The chula knot: a new sliding locking knot with a special property.

Project description:There are many types of sliding locking knots used in arthroscopic surgery. Each type has its advantages and disadvantages. This technical note describes a new sliding locking knot, the Chula knot. This knot has been used for arthroscopic shoulder surgery in more than 500 cases at our hospital. The Chula knot has a special property in that it can be unfastened and retightened in case of premature locking and unintended loop loosening. This retensioning ability cannot be found in other configurations of arthroscopic knots. The Chula knot also has other benefits: It has high ultimate tensile strength and is easy to tie.

| S-EPMC4175540 | biostudies-literature

The Sliding, Interlocking "8-2-Alpha Knot" for Arthroscopic Surgery.

Project description:We describe a sliding knot that is ideally lockable by transforming the original simple figure-of-8 configuration into a true interlocking, low-profile knot with an ?-? configuration that creates strong primary knot security when tying is finished. Reversed half-hitches on alternating posts for secondary knot security can be added, but to save surgical time, these are not obligatory. Three simple knot-tying methods are presented; the choice of which to use is based on the surgeon's preference. Pulling the loop limb simultaneously on both sides of the knot could trigger premature knot flipping. Therefore, the loop limb should not be over-tensioned while sliding down the knot; the knot should always be "pulled" down, rather than "pushed" down, onto the target tissues. Because all loops would be disassembled after the post limb is removed from the knot, a salvage procedure is proposed to save the suture from unintentional premature locking.

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Project description:In arthroscopic tissue repair, the final step is achieving adequate tissue approximation with a secure knot. The sliding knot is widely preferred over the nonsliding knot, with numerous publications describing knot configurations. However, in the literature there are few published descriptions of suture-handling techniques, even though they are fundamental to arthroscopic knot tying. We describe integral suture-handling techniques for arthroscopic sliding knots to improve the surgeon's performance in knot tying.

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Orthopaedic Resident Arthroscopic Knot-Tying Skills Are Improved Using a Training Program and Knot-Tying Workstation.

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Project description: Not available

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X-Grab: An Arthroscopic Maneuver to Efficiently and Accurately Track the Post for Knot Tying.

Project description:Numerous studies have analyzed techniques for producing reliable and efficient arthroscopic knots. All aspects have been explored, from the biomechanics and strength to the ability to teach and replicate at all levels of training. This technique article describes an additional maneuver (X-grab) for efficiently marking the post side of the arthroscopic knot without having to do this separately outside of the joint. This is most useful for procedures such as rotator cuff repair and capsular repair or plication in hip arthroscopy in which the location of the knot (i.e., the post) is critical. The aim of this Technical Note is to describe the X-grab maneuver, which shortens this process to a single step, limiting the see-sawing of sutures and over-instrumentation of the joint seen with other techniques.

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