Southern California Orthopedic Institute, Van Nuys, CA 91405, USA.
Arthroscopy. 2013 Jul;29(7):1175-81. doi: 10.1016/j.arthro.2013.04.012.
To compare the biomechanical, time, and profile characteristics of a new sliding locking knot termed the slippage-proof knot (SPK) and a modified slippage-proof knot (MSPK) with those of traditional arthroscopic knots.
We evaluated the Samsung Medical Center (SMC) knot, Revo knot, SPK, and MSPK (an SPK with a single added half-hitch) tied with high-strength suture, with 11 trials of each cycled 1,000 times between 10 and 45 N and then loaded to failure. Total displacement during cyclical testing, maximal load to failure, and mode of failure were recorded for each knot. We also measured the dimensions of the knots and the time required to tie each knot.
On load-to-failure testing, no difference in strength was found between the SMC and Revo knots (P = .082). The Revo knot and MSPK were also of equivalent strength (P = .183), and the SMC knot was 11% stronger than the MSPK (P = .017). All 3 of these knots were stronger than the SPK. On cyclical testing, the SMC knot, Revo knot, and MSPK allowed equivalent total displacement and allowed statistically less total displacement than the SPK. All SMC knots, Revo knots, and MSPKs failed by suture breakage, whereas the SPKs all slipped at failure. We found that the SPKs and MSPKs are tied more quickly than traditional knots. The SPK and MSPK dimensions are wider yet shorter than those of the other knots in the study.
Our results indicate that the MSPK has biomechanical properties comparable to the SMC and Revo knots despite only requiring 1 added half-hitch, whereas the SPK was found to be significantly inferior to the other knots tested. We found that the slippage-proof knots (SPK and MSPK) were tied more quickly and have shorter, wider profiles than traditional knots.
The MSPK has knot security comparable to the SMC and Revo knots while requiring only 1 added half-hitch, and it may be most beneficial in cases in which a large number of knots will be tied because the fewer required half-hitches reduces the surgical time without reducing its biomechanical properties.
比较一种新型滑动锁定结（SPK）和改良滑动锁定结（MSPK）与传统关节镜结的生物力学、时间和形态特征。
我们评估了三星医疗中心（SMC）结、Revo 结、SPK 和 MSPK（带有单个附加半结的 SPK），用高强度缝线进行了 11 次循环试验，每次循环在 10 至 45N 之间循环 1000 次，然后进行失效负载测试。记录每个结的循环测试中的总位移、最大失效负载和失效模式。我们还测量了结的尺寸和系结每个结所需的时间。
在失效负载测试中，SMC 结和 Revo 结的强度没有差异（P=0.082）。Revo 结和 MSPK 的强度也相同（P=0.183），SMC 结比 MSPK 强 11%（P=0.017）。所有这 3 种结都比 SPK 强。在循环测试中，SMC 结、Revo 结和 MSPK 允许相同的总位移，并允许比 SPK 统计学上更小的总位移。所有 SMC 结、Revo 结和 MSPK 都因缝线断裂而失效，而 SPK 则在失效时滑脱。我们发现 SPK 和 MSPK 的系结速度比传统结更快。SPK 和 MSPK 的尺寸比研究中的其他结更宽但更短。
我们的结果表明，尽管 MSPK 只需要增加 1 个半结，但它的生物力学特性与 SMC 和 Revo 结相当，而 SPK 明显劣于其他测试结。我们发现，防滑脱结（SPK 和 MSPK）系结速度更快，且与传统结相比，其轮廓更短、更宽。
MSPK 具有与 SMC 和 Revo 结相当的结安全性，而只需增加 1 个半结，在需要系结大量结的情况下，它可能最有益，因为所需的半结更少，可减少手术时间，而不会降低其生物力学特性。
