The modified racking hitch(MRH) knot: a new sliding knot for arthroscopic surgery.

Sliding knots are commonly used in arthroscopic surgery and can be problematic in terms of strength and loop security. A new sliding knot for arthroscopic surgery, a modified racking hitch (MRH) knot, is described. The knot is essentially a modified cow's hitch knot that includes two self-locking loops. By tensioning the loop strands, a snug knot is created without backward sliding and provides excellent knot and loop security. In laboratory testing, the MRH knot provided comparable strength and security to other sliding knots. Experience gained from approximately 5 years of clinical use has added to the promise of the useful application of the MRH knot in arthroscopy.