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knot less anchor

Toshihiro Nishizawa, Yasutoshi Ochiai, Toshio Uraoka, Teppei Akimoto, Yutaka Mitsunaga, Osamu Goto, Ai Fujimoto, Tadateru Maehata, Takanori Kanai, Naohisa Yahagi
BACKGROUND AND AIMS: We developed a suturing method with a slip-knot string and clips for a single-channel endoscope. The feasibility of the slip-knot clip suturing method was evaluated in this clinical pilot study. METHODS: Ten patients underwent endoscopic submucosal dissection for colorectal and duodenal tumors 5 cm or less. A slip-knot loop can be tightened when tension is applied to the free end of the string. A clip and string can be passed through an instrument channel (3...
July 27, 2016: Gastrointestinal Endoscopy
Florence L Chiang, Chih-Kai Hong, Chih-Hsun Chang, Cheng-Li Lin, I-Ming Jou, Wei-Ren Su
PURPOSE: To compare the biomechanical characteristics of the subpectoral Y-knot all-suture anchor fixation with those of the interference screw technique. METHODS: Sixteen fresh-frozen human cadaveric shoulders with a mean age of 67.6 ± 5.8 years (range, 52 to 74 years) were studied. The specimens were randomly grouped into 2 experimental biceps tenodesis groups (n = 8): Y-knot all-suture anchor or interference screw. The specimens were cyclically tested to failure by applying tensile forces parallel to the longitudinal axis of the humerus...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Richard L Angelo, Robert A Pedowitz, Richard K N Ryu, Anthony G Gallagher
PURPOSE: To determine if a dry shoulder model simulator coupled with previously validated performance metrics for an arthroscopic Bankart repair (ABR) would be a valid tool with the ability to discriminate between the performance of experienced and novice surgeons, and to establish a proficiency benchmark for an ABR using a model simulator. METHODS: We compared an experienced group of arthroscopic shoulder surgeons (Arthroscopy Association of North America faculty) (n = 12) with a novice group (n = 7) (postgraduate year 4 or 5 orthopaedic residents)...
September 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Yongcheol Park
After the importance of the deep fiber of the distal radioulnar ligament had been acknowledged, some repair techniques have been introduced. Because the knotless suture anchor does not cause any knot irritation and yields appropriate tension, it is a useful fixation material. All-arthroscopic knotless suture anchor repair of the triangular fibrocartilage complex fovea tear by a 2-portal technique is easier and less vulnerable to ulnar nerve injury than the original Geissler technique. Instead of the suture hook and accessory portal, this technique uses the always-sharp 18-gauge needle and percutaneous route...
December 2014: Arthroscopy Techniques
Jacques Rizkallah, John M Rothschild, Derek V Exner
The ability to tie surgical knots efficiently and effectively is an essential surgical skill for medical procedures, especially pacemaker implantation. Device generators and their leads need to be safely anchored with sutures during implantation to prevent dislodgement and inadequate packaging in the pacemaker pocket. With most knot tying techniques, a generous amount of suture slack is required. We introduce a new technique that is a variation of the 2-handed surgical square knot and the 1-handed surgeon's knot that allows one to finish or tie a knot when left with little slack...
December 2014: Canadian Journal of Surgery. Journal Canadien de Chirurgie
B S Perry, T A Harper, M A Mitchell, M S McFadden, B Heggem Perry
OBJECTIVE: To compare the ultimate tensile strength (UTS) and load to 1 and 3 mm gap formation of smooth (3-metric) and knotless barbed (4-metric) polypropylene sutures placed in a three-loop pulley pattern for canine gastrocnemius tendon repair. STUDY DESIGN: In vitro. SAMPLE SIZE: Thirty-three paired bone-tendon units with one of each pair assigned to each suture type. Barbed suture size was based on previously published materials testing results...
2014: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Timothy S Johnson, Christine M DiPompeo, Zahra C Ismaeli, Polly A Porter, Shannon L Nicholson, David C Johnson
Recurrent shoulder instability often leads to labral abnormality that requires surgical intervention that may require fixation with suture anchors. The proposed surgical technique allows the surgeon to achieve 2 points of fixation around the labrum and/or capsule with a single suture secured to the glenoid with a knotless anchor. Instead of cutting and discarding the residual suture limbs after anchor insertion, this technique uses the residual suture limbs of the knotless anchor for a second suture pass. This technique (1) creates a more cost- and time-efficient surgical procedure than using multiple single-loaded anchors or double-loaded anchors, (2) decreases the known risk of glenoid fracture from the stress riser at the implant tips of multi-anchor repairs by reducing the number of anchors required for stabilization, (3) decreases the surgical time compared with the use of double-loaded anchors through simpler suture management and less knot tying, (4) allows for the secure reapproximation of the labrum to the glenoid while offering a convenient option for capsulorrhaphy without the need to insert another anchor, and (5) yields more points of soft-tissue fixation with fewer anchors drilled into the glenoid...
June 2014: Arthroscopy Techniques
James A Greenberg, Randi H Goldman
Surgical knots are simply a necessary evil needed to anchor smooth suture to allow it to function in its role in tissue reapproximation. Surgical knots reduce the tensile strength of all sutures by thinning and stretching the material. The tying of surgical knots introduces the potential of human error and interuser variability. Knot-secured smooth suture must create an uneven distribution of tension across the wound with the higher tension burdens placed at the knots. Given the excessive relative wound tension on the knot and the reasonable concerns of surgeons for suture failure due to knot slippage, there is a natural tendency toward overcoming these concerns by over-tightening knots; however, tighter knots may be worse for wound healing and strength than looser knots...
2013: Reviews in Obstetrics and Gynecology
Candice Y Lee, Jude S Sauer, Heather R Gorea, Angelo J Martellaro, Peter A Knight
OBJECTIVE: This study compared the strength, consistency, and speed of prosthetic attachment sutures secured with automated fasteners with those of manual knots using an ex vivo porcine mitral valve annuloplasty model. A novel miniature pressure transducer system was developed to quantify pressures between sutured prosthetic rings and underlying cardiac tissue. METHODS: Sixteen mitral annuloplasty rings were sewn into ex vivo pig hearts. Eight rings were secured with the COR-KNOT device; and eight rings, with hand-tied knots using a knot pusher...
March 2014: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Duncan Tennent, Chiara Concina, Eyiyemi Pearse
Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head...
February 2014: Arthroscopy Techniques
Mallika Tamboli, Teruhisa Mihata, James Hwang, Michelle H McGarry, Yangmi Kang, Thay Q Lee
BACKGROUND: We investigated the effects of bite-size horizontal mattress stitch (distance between the limbs passed through the tendon) on the biomechanical properties of the repaired tendon. METHODS: We anchored 20 bovine Achilles tendons to bone using no. 2 high-strength suture and 5-mm titanium suture anchors in a mattress-suture technique. Tendons were allocated randomly into two groups of ten each to receive stitches with a 4- or 10-mm bite. Specimens underwent cyclic loading from 5 to 30 N at 1 mm/s for 30 cycles, followed by tensile testing to failure...
March 2014: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Maxwell C Park, Alexander Peterson, John Patton, Michelle H McGarry, Chong J Park, Thay Q Lee
BACKGROUND: Rotator cuff repair involving fewer tendon suture passes without compromising biomechanical performance would represent a technical advancement. An inter-implant "medial pulley-mattress" transosseous-equivalent (MP-TOE) repair requiring fewer tendon suture-passes was hypothesized to provide equivalent biomechanical characteristics compared to the control. METHODS: In 6 human cadaveric shoulders, a transosseous-equivalent (TOE) repair (control) was performed utilizing 2 separate medial mattresses resulting in 4 tendon-bridging sutures...
March 2014: Journal of Shoulder and Elbow Surgery
Jeffrey S Staron, Amanda O Esquivel, Nikhil G Pandhi, Jason D Hanna, Stephen E Lemos
Methods to reconstruct the coracoclavicular ligaments anatomically have been described. No clear advantage of 1 technique has been elucidated. The authors' hypothesis was that the biomechanical properties of a modified knot fixation technique would be similar to the anatomical double-bundle technique. Sixteen matched cadaveric shoulders were used for this study, and 1 additional shoulder was used in the knot fixation group only. Shoulders were randomly assigned to the anatomical double-bundle coracoclavicular ligament reconstruction technique (n=8) or a knot fixation technique (n=9)...
August 2013: Orthopedics
F Alan Barber, Morley A Herbert, John M Crates
BACKGROUND: Lateral ankle ligament repairs increasingly use suture anchors instead of bone tunnels. Our purpose was to compare the biomechanical properties of a knotted and knotless suture anchor appropriate for a lateral ankle ligament reconstruction. METHODS: In porcine distal fibulae, 10 samples of 2 different PEEK anchors were inserted. The attached sutures were cyclically loaded between 10N and 60N for 200 cycles. A destructive pull was performed and failure loads, cyclic displacement, stiffness, and failure mode recorded...
June 2013: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Gang Yin, Woong Kyu Han, Stephen Faddegon, Yung Khan Tan, Zhuo-Wei Liu, Ephrem O Olweny, Daniel J Scott, Jeffrey A Cadeddu
OBJECTIVE: To compare the ergonomics and workload of the surgeon during single-site suturing while using the magnetic anchoring and guidance system (MAGS) camera vs a conventional laparoscope. METHODS: Seven urologic surgeons were enrolled and divided into an expert group (n=2) and a novice group (n=5) according to their laparoendoscopic single-site (LESS) experience. Each surgeon performed 2 conventional LESS and 2 MAGS camera-assisted LESS vesicostomy closures in a porcine model...
January 2013: Urology
Calvin Lyons, Rohan Joseph, Nilson Salas, Patrick R Reardon, Barbara L Bass, Brian J Dunkin
BACKGROUND: Laparoscopic ventral hernia repair using an underlay mesh frequently requires suture fixation across the abdominal wall, which results in significant postoperative pain. This study investigates the utility of a novel mesh fixation technique to reduce the strangulation force on the abdominal wall. METHODS: Multiple 2-cm(2) pieces of polyester mesh (Parietex Composite, Covidien) were placed as an underlay against a porcine abdominal wall. Fixation was accomplished using either the standard 0-polyglyconate or the 0-polyglyconate barbed anchor suture designed to hold in tissue without the need to tie a knot (V-Loc 180; Covidien)...
May 2012: Surgical Endoscopy
Marc Tompkins, Keith O Monchik, Matthew J Plante, Braden C Fleming, Paul D Fadale
PURPOSE: To evaluate whether the use of knotless lateral anchors in a suture bridge construct produces better contact area and pressure parameters than a suture bridge construct with standard lateral anchors that require knots or a double-row repair. The hypothesis was that knotless lateral anchors would produce better contact area and pressure parameters than the other two constructs. METHODS: A total of fifteen matched pairs of cadaveric shoulders were divided into three groups...
October 2011: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kevin Kaplan, Neal S ElAttrache, Oscar Vazquez, Yu-Jen Chen, Thay Lee
PURPOSE: To evaluate the effect of the addition of 2 horizontal mattress knots to the medial row of a knotless rotator cuff construct on the biomechanical properties in terms of both cyclic and failure testing parameters in an external rotation model. METHODS: In 8 fresh-frozen human cadaveric shoulders, a knotless transosseous repair was performed, whereas in 8 contralateral matched-pair specimens, 2 horizontal mattress knots were added to the medial-row fixation...
April 2011: Arthroscopy: the Journal of Arthroscopic & related Surgery
Nasir Muzaffar, Jung-Ro Yoon, Youngbae B Kim
BACKGROUND: We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop. METHODS: With the arthroscope laterally, a spinal needle looped with PDS is inserted percutaneously into the shoulder posteriorly and penetrated through the healthy posterior cuff tear margin. Anteriorly, another spinal needle loaded with PDS is inserted percutaneously to engage the healthy tissue at the anterior tear margin. The suture in the anterior needle is then delivered into the suture loop of the posterior needle using a suture retriever...
2010: Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology: SMARTT
Wolf Petersen, Mathias Wellmann, Steffen Rosslenbroich, Thore Zantop
OBJECTIVE: Reduction and retention of an acromioclavicular (AC) joint dislocation with a button/suture augmentation cerclage (Flip tack, Karl Storz, Tuttlingen, Germany). INDICATIONS: Dislocation of the AC joint (Rockwood III and V). Chronic instabilities in combination with autogenous replacement of the coracoclavicular ligaments. Lateral clavicular fracture with rupture of the coracoclavicular ligaments. CONTRAINDICATIONS: Patients in poor general condition...
March 2010: Operative Orthopädie und Traumatologie
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