Cyclic Load and Failure Behavior of Arthroscopic Knots and High Strength Sutures
Bibliographic record
Abstract
PURPOSE: To compare the biomechanical performance of several different sutures by evaluating knot security and load to failure strength using different arthroscopic knots. METHODS: Eight different No. 2 sutures (Ethibond [Ethicon, Somerville, NJ], FiberWire [Arthrex, Naples, FL], Orthocord [DePuy-Mitek, Norwood, MA], Hi-Fi [ConMed Linvatec, Largo, FL], Ultrabraid [Smith & Nephew, Andover, MA], ForceFiber [Stryker Endoscopy, San Jose, CA], MagnumWire [ArthroCare, Sunnyvale, CA], and MaxBraid PE [Arthrotek, Warsaw, IN]) were tied arthroscopically into standardized loops using 6 different knots (Weston, Tennessee slider, Duncan, SMC, Revo, and San Diego knot) 10 times each. The suture loops were pretensioned to 10N, cycled between 10N and 45N for 1,000 cycles, and loaded to failure. The failure load for each suture, each knot, and slippage trend during cyclic loading was recorded. RESULTS: The Revo and SMC knots (group A) were stronger than the Tennessee and San Diego knots (group B), which were stronger than the Weston knot, which was stronger than the Duncan loop (P < .05). This pattern also coincided with the loads at which these knots slipped. Evaluating the sutures showed that Ethibond had lower failure loads than all other sutures and FiberWire showed statistically higher loads (P < .05). Duncan loops (97.5%) and Weston knots (86.3%) slipped more than other knots (P < .001), while the SMC and Revo knots slipped least. Ethibond sutures were least likely to slip. CONCLUSIONS: The Duncan loop and Weston knot were more likely to slip than all other knots, and caution should be exercised when tying them with high-strength sutures. The Revo, Tennessee slider, San Diego, and SMC knots were least likely to slip (P < .001). CLINICAL RELEVANCE: While stronger than braided polyester sutures, newer sutures containing ultra-high molecular weight polyethylene have a greater tendency to slip. Backing up knots with 4 reversed half hitches with switched posts does not guarantee knot security.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".