Kim S H, Ha K I, Kim S H, Kim J S
Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, and Sungkyunkwan University Sports Medicine Institute, Seoul, Korea.
Arthroscopy. 2001 Oct;17(8):850-5. doi: 10.1016/s0749-8063(01)90009-x.
Secure tissue fixation of an arthroscopic knot depends on the security of the initial loop and additional locking half-hitches. The purpose of this report is to evaluate the loop and knot security relative to the internal locking mechanism of arthroscopic slip knot.
This is an experimental study designed for knot and loop security on a material testing system. The measurements were carried out in a blinded fashion in which the tester was not aware of the type of knot being tested.
Five configurations of arthroscopic knots (overhand throw, Duncan loop, Revo knot, Tennessee slider, and SMC knot) were created around a 5-mm diameter metal bar using a No. 2 braided suture. For each knot configuration, 10 knots were tested for displacement at cyclic loading, load to clinical failure (3-mm displacement), ultimate failure load, and mode of failure on the servo-hydraulic material testing system (MTS 858 MiniBionix test system; MTS, Minneapolis, MN). A 1-way analysis of variance was used to determine the statistical difference in displacement at cyclic loading, load to clinical failure, and ultimate failure load between each knot configuration.
In the cyclic loading test, the average displacement of all knots was clinically insignificant, with the average being less than 0.24 mm. The overhand throw had the worst characteristic in the load to failure test. The other 4 knots had an optimal load to failure. The SMC knot, which has an internal locking mechanism, had good loop and knot security in the load to clinical failure and ultimate failure load (P <.05). The SMC and the Revo knots failed by knot breakage (material failure) whereas the other knots failed by knot slippage (loop failure).
The internal locking mechanism flips the post strand to convert the loop strand into a new post strand while rerouting the original post strand around a new post. An arthroscopic knot with an internal locking mechanism can enhance loop security.
关节镜下结的可靠组织固定取决于初始环和额外锁定半结的安全性。本报告的目的是评估相对于关节镜滑结内部锁定机制的环和结的安全性。
这是一项在材料测试系统上针对结和环安全性设计的实验研究。测量以盲法进行，测试者不知道所测试结的类型。
使用2号编织缝线在一根5毫米直径的金属棒周围制作五种关节镜下结的构型（单结、邓肯环、Revo结、田纳西滑块结和SMC结）。对于每种结构型，在伺服液压材料测试系统（MTS 858 MiniBionix测试系统；MTS，明尼阿波利斯，明尼苏达州）上测试10个结在循环加载时的位移、临床失败载荷（3毫米位移）、极限失败载荷和失败模式。采用单向方差分析来确定每种结构型在循环加载时的位移、临床失败载荷和极限失败载荷之间的统计学差异。
在循环加载测试中，所有结的平均位移在临床上无显著意义，平均值小于0.24毫米。单结在失败载荷测试中表现最差。其他4种结具有最佳的失败载荷。具有内部锁定机制的SMC结在临床失败载荷和极限失败载荷方面具有良好的环和结安全性（P<.05）。SMC结和Revo结因结断裂（材料失效）而失败，而其他结因结滑动（环失效）而失败。
内部锁定机制翻转后股线，将环股线转换为新的后股线，同时将原始后股线重新围绕新的后股线进行布线。具有内部锁定机制的关节镜下结可增强环的安全性。
