Arthrosopic knot pushers. Does one size fit all?
Summary Little is known about how knot‐pusher design affects arthroscopic knot tying. In our practice, we observed the knot‐pusher riding onto the arthroscopic knot at the point of maximum tightening. This can lead to snagging of the knot, which is undesirable as it may lead to loosening of, or dama...
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Veröffentlicht in: | International journal of clinical practice (Esher) 2008-05, Vol.62 (5), p.747-749 |
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description | Summary
Little is known about how knot‐pusher design affects arthroscopic knot tying. In our practice, we observed the knot‐pusher riding onto the arthroscopic knot at the point of maximum tightening. This can lead to snagging of the knot, which is undesirable as it may lead to loosening of, or damage to the knot. The aim of this study is to determine the optimum size of a knot‐pusher to efficiently push the knot without overriding or snagging it.We used an apparatus to model arthropcopic knot tying. Ten examples each of the Duncan loop were tied under controlled conditions of load using one polydioxanone (PDS) monofilament absorbable suture (Ethicon, Livingston, UK), two Ethibond, two Fibrewire and two Panacryl. The loop of the knot was then secured and a 50 N force applied to tension the knot. The suture diameter was measured. Then the knot diameter was measured in two planes using an analogue micrometer. The internal diameter of a Mitek knot‐pusher was measured.The mean maximum diameter for each knot was respectively PDS, 2.061 ± 0.13 mm; Panacryl, 1.907 ± 0.14 mm; Ethibond, 1.717 ± 0.16 mm and Fibrewire, 1.654 ± 0.14 mm. There were significant differences in size between knots tied with different materials except between Ethibond and Fibrewire where the difference was not significant. For each set of knots the smallest maximum knot diameter observed was identified. This was respectively PDS, 1.92 mm; Ethibond, 1.476 mm; Fibrewire, 1.488 mm and Panacryl, 1.715 mm. The internal diameter of a Mitek knot‐pusher was found to be 1.95 mm.The current Mitek knot‐pusher appears to be well suited to one PDS and two Panacryl. It appears less ideal for two Ethibond and two Fibrewire. One knot‐pusher does not fit all and we suggest that different knot‐pushers be used for different suture materials. |
doi_str_mv | 10.1111/j.1742-1241.2006.01263.x |
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Little is known about how knot‐pusher design affects arthroscopic knot tying. In our practice, we observed the knot‐pusher riding onto the arthroscopic knot at the point of maximum tightening. This can lead to snagging of the knot, which is undesirable as it may lead to loosening of, or damage to the knot. The aim of this study is to determine the optimum size of a knot‐pusher to efficiently push the knot without overriding or snagging it.We used an apparatus to model arthropcopic knot tying. Ten examples each of the Duncan loop were tied under controlled conditions of load using one polydioxanone (PDS) monofilament absorbable suture (Ethicon, Livingston, UK), two Ethibond, two Fibrewire and two Panacryl. The loop of the knot was then secured and a 50 N force applied to tension the knot. The suture diameter was measured. Then the knot diameter was measured in two planes using an analogue micrometer. The internal diameter of a Mitek knot‐pusher was measured.The mean maximum diameter for each knot was respectively PDS, 2.061 ± 0.13 mm; Panacryl, 1.907 ± 0.14 mm; Ethibond, 1.717 ± 0.16 mm and Fibrewire, 1.654 ± 0.14 mm. There were significant differences in size between knots tied with different materials except between Ethibond and Fibrewire where the difference was not significant. For each set of knots the smallest maximum knot diameter observed was identified. This was respectively PDS, 1.92 mm; Ethibond, 1.476 mm; Fibrewire, 1.488 mm and Panacryl, 1.715 mm. The internal diameter of a Mitek knot‐pusher was found to be 1.95 mm.The current Mitek knot‐pusher appears to be well suited to one PDS and two Panacryl. It appears less ideal for two Ethibond and two Fibrewire. One knot‐pusher does not fit all and we suggest that different knot‐pushers be used for different suture materials.</description><identifier>ISSN: 1368-5031</identifier><identifier>EISSN: 1742-1241</identifier><identifier>DOI: 10.1111/j.1742-1241.2006.01263.x</identifier><identifier>PMID: 17263695</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Arthroscopy ; Biological and medical sciences ; Equipment Design ; General aspects ; Humans ; Materials Testing - methods ; Medical equipment ; Medical sciences ; Medical supplies ; Models, Anatomic ; Surgical techniques ; Suture Techniques - instrumentation ; Sutures</subject><ispartof>International journal of clinical practice (Esher), 2008-05, Vol.62 (5), p.747-749</ispartof><rights>2007 The Authors</rights><rights>2008 INIST-CNRS</rights><rights>Journal compilation © 2008 Blackwell Publishing Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4143-45c0b53bae8f68311394e016c6c409afa92f9258114e954c84c383334a8a110d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1742-1241.2006.01263.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1742-1241.2006.01263.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20262529$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17263695$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kerin, C.</creatorcontrib><creatorcontrib>Patel, N.</creatorcontrib><creatorcontrib>Bale, R. S.</creatorcontrib><creatorcontrib>Fisher, A. C.</creatorcontrib><creatorcontrib>Hughes, P. J.</creatorcontrib><title>Arthrosopic knot pushers. Does one size fit all?</title><title>International journal of clinical practice (Esher)</title><addtitle>Int J Clin Pract</addtitle><description>Summary
Little is known about how knot‐pusher design affects arthroscopic knot tying. In our practice, we observed the knot‐pusher riding onto the arthroscopic knot at the point of maximum tightening. This can lead to snagging of the knot, which is undesirable as it may lead to loosening of, or damage to the knot. The aim of this study is to determine the optimum size of a knot‐pusher to efficiently push the knot without overriding or snagging it.We used an apparatus to model arthropcopic knot tying. Ten examples each of the Duncan loop were tied under controlled conditions of load using one polydioxanone (PDS) monofilament absorbable suture (Ethicon, Livingston, UK), two Ethibond, two Fibrewire and two Panacryl. The loop of the knot was then secured and a 50 N force applied to tension the knot. The suture diameter was measured. Then the knot diameter was measured in two planes using an analogue micrometer. The internal diameter of a Mitek knot‐pusher was measured.The mean maximum diameter for each knot was respectively PDS, 2.061 ± 0.13 mm; Panacryl, 1.907 ± 0.14 mm; Ethibond, 1.717 ± 0.16 mm and Fibrewire, 1.654 ± 0.14 mm. There were significant differences in size between knots tied with different materials except between Ethibond and Fibrewire where the difference was not significant. For each set of knots the smallest maximum knot diameter observed was identified. This was respectively PDS, 1.92 mm; Ethibond, 1.476 mm; Fibrewire, 1.488 mm and Panacryl, 1.715 mm. The internal diameter of a Mitek knot‐pusher was found to be 1.95 mm.The current Mitek knot‐pusher appears to be well suited to one PDS and two Panacryl. It appears less ideal for two Ethibond and two Fibrewire. One knot‐pusher does not fit all and we suggest that different knot‐pushers be used for different suture materials.</description><subject>Arthroscopy</subject><subject>Biological and medical sciences</subject><subject>Equipment Design</subject><subject>General aspects</subject><subject>Humans</subject><subject>Materials Testing - methods</subject><subject>Medical equipment</subject><subject>Medical sciences</subject><subject>Medical supplies</subject><subject>Models, Anatomic</subject><subject>Surgical techniques</subject><subject>Suture Techniques - instrumentation</subject><subject>Sutures</subject><issn>1368-5031</issn><issn>1742-1241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1LHDEUhoO0-NX-BRmE9m6mOfma5EaxW7WKbKVUvDxkYwZnnZ1Zkxm69tc3425X6LnJgTw8HN6XkAxoAWm-zAsoBcuBCSgYpaqgwBQvVjtkf_vxLu1c6VxSDnvkIMY5pUxKTXfJHpQJV0buE3oW-sfQxW5Zu-yp7fpsOcRHH2KRfet8zLrWZ7H-47Oq7jPbNKcfyPvKNtF_3LyH5O7i_Nfke37z4_JqcnaTOwGC50I6OpN8Zr2ulOYA3AhPQTnlBDW2soZVhkkNILyRwmnhuOacC6stAH3gh-Tz2rsM3fPgY4-LOjrfNLb13RBRGaACGE_g8X_gvBtCm25Dxow2ugSVoKMNNMwW_gGXoV7Y8IL_gkjApw1go7NNFWzr6rjlGGWKSWYSd7LmfteNf3nzUByLwTmO-eOYP47F4GsxuMKr68ntuCZBvhbUsferrcCGJ1QlLyXeTy9x-pWa6a34iYr_BViai9M</recordid><startdate>200805</startdate><enddate>200805</enddate><creator>Kerin, C.</creator><creator>Patel, N.</creator><creator>Bale, R. S.</creator><creator>Fisher, A. C.</creator><creator>Hughes, P. J.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Hindawi Limited</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200805</creationdate><title>Arthrosopic knot pushers. Does one size fit all?</title><author>Kerin, C. ; Patel, N. ; Bale, R. S. ; Fisher, A. C. ; Hughes, P. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4143-45c0b53bae8f68311394e016c6c409afa92f9258114e954c84c383334a8a110d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Arthroscopy</topic><topic>Biological and medical sciences</topic><topic>Equipment Design</topic><topic>General aspects</topic><topic>Humans</topic><topic>Materials Testing - methods</topic><topic>Medical equipment</topic><topic>Medical sciences</topic><topic>Medical supplies</topic><topic>Models, Anatomic</topic><topic>Surgical techniques</topic><topic>Suture Techniques - instrumentation</topic><topic>Sutures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kerin, C.</creatorcontrib><creatorcontrib>Patel, N.</creatorcontrib><creatorcontrib>Bale, R. S.</creatorcontrib><creatorcontrib>Fisher, A. C.</creatorcontrib><creatorcontrib>Hughes, P. J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical practice (Esher)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kerin, C.</au><au>Patel, N.</au><au>Bale, R. S.</au><au>Fisher, A. C.</au><au>Hughes, P. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Arthrosopic knot pushers. Does one size fit all?</atitle><jtitle>International journal of clinical practice (Esher)</jtitle><addtitle>Int J Clin Pract</addtitle><date>2008-05</date><risdate>2008</risdate><volume>62</volume><issue>5</issue><spage>747</spage><epage>749</epage><pages>747-749</pages><issn>1368-5031</issn><eissn>1742-1241</eissn><abstract>Summary
Little is known about how knot‐pusher design affects arthroscopic knot tying. In our practice, we observed the knot‐pusher riding onto the arthroscopic knot at the point of maximum tightening. This can lead to snagging of the knot, which is undesirable as it may lead to loosening of, or damage to the knot. The aim of this study is to determine the optimum size of a knot‐pusher to efficiently push the knot without overriding or snagging it.We used an apparatus to model arthropcopic knot tying. Ten examples each of the Duncan loop were tied under controlled conditions of load using one polydioxanone (PDS) monofilament absorbable suture (Ethicon, Livingston, UK), two Ethibond, two Fibrewire and two Panacryl. The loop of the knot was then secured and a 50 N force applied to tension the knot. The suture diameter was measured. Then the knot diameter was measured in two planes using an analogue micrometer. The internal diameter of a Mitek knot‐pusher was measured.The mean maximum diameter for each knot was respectively PDS, 2.061 ± 0.13 mm; Panacryl, 1.907 ± 0.14 mm; Ethibond, 1.717 ± 0.16 mm and Fibrewire, 1.654 ± 0.14 mm. There were significant differences in size between knots tied with different materials except between Ethibond and Fibrewire where the difference was not significant. For each set of knots the smallest maximum knot diameter observed was identified. This was respectively PDS, 1.92 mm; Ethibond, 1.476 mm; Fibrewire, 1.488 mm and Panacryl, 1.715 mm. The internal diameter of a Mitek knot‐pusher was found to be 1.95 mm.The current Mitek knot‐pusher appears to be well suited to one PDS and two Panacryl. It appears less ideal for two Ethibond and two Fibrewire. One knot‐pusher does not fit all and we suggest that different knot‐pushers be used for different suture materials.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17263695</pmid><doi>10.1111/j.1742-1241.2006.01263.x</doi><tpages>3</tpages></addata></record> |
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subjects | Arthroscopy Biological and medical sciences Equipment Design General aspects Humans Materials Testing - methods Medical equipment Medical sciences Medical supplies Models, Anatomic Surgical techniques Suture Techniques - instrumentation Sutures |
title | Arthrosopic knot pushers. Does one size fit all? |
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