Geisinger Medical Center, Danville, PA, United States of America.
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, United States of America.
Clin Biomech (Bristol). 2021 Dec;90:105486. doi: 10.1016/j.clinbiomech.2021.105486. Epub 2021 Sep 17.
The success of surgical repairs rely on the effectiveness and integrity of the surgical knots used to secure the repair. The purpose of this study is to examine and compare the performance of the Nice knot, the modified Nice knot, and a commonly used combination of surgeons' and square knots with respect to cyclic loading and load-to-failure usiflueng a high-strength suture composed of ultra-high molecular weight polyethylene in the hands of experienced surgeons.
Two experienced surgeons threw 3 different knot types 9 times, consisting of the Nice knot, modified Nice knot, and a surgeon's knot utilizing Ultrabraid #2 sutures. Each knot was subject to cyclic loading and load to failure testing.
Both surgeons had similar displacement data for the surgeon's knot, while the identity of the surgeon impacted displacement for the Nice knot (p = 0.03) and the modified Nice knot (p = 0.0002). The load to failure for the modified Nice knot (p < 0.001) and the Nice knot (p = 0.001) were significantly impacted by the surgeon tying the knot, while the surgeon's knot was not. Specimens failed where the sutures passed through the loop at the "base" of the knot.
The strength and integrity of complex surgical knots are variable between surgeons. While the proposed Modified Nice Knot has a theoretical advantage because the half hitches reinforce the primary knot, in load to failure testing both the Modified Nice Knot and the Nice Knot failed where the suture passed through the loop in the primary knot.
手术修复的成功依赖于用于固定修复的手术结的有效性和完整性。本研究的目的是检查和比较在经验丰富的外科医生手中，高强度超高分子量聚乙烯缝线的循环加载和失效负载性能方面，Nice 结、改良 Nice 结和常用的外科结和方结的组合。
两位经验丰富的外科医生各投掷 3 种不同类型的结 9 次，包括 Nice 结、改良 Nice 结和外科结，使用 Ultrabraid #2 缝线。每个结都进行了循环加载和失效负载测试。
两位外科医生的外科结的位移数据相似，而外科医生的身份影响了 Nice 结（p = 0.03）和改良 Nice 结（p = 0.0002）的位移。改良 Nice 结（p < 0.001）和 Nice 结（p = 0.001）的失效负载受到打结外科医生的显著影响，而外科结则不受影响。缝线在结“底部”穿过环的地方发生了标本失效。
复杂外科结的强度和完整性在外科医生之间存在差异。虽然改良 Nice 结具有理论优势，因为半结可以加强主结，但在失效负载测试中，改良 Nice 结和 Nice 结都在缝线穿过主结的环的地方失效。
