Biomechanical comparison of four sliding knots and three high-strength sutures: Loop security is much different between each combination.

There are many types of sliding knots and suture materials used in arthroscopic surgery. The purposes of this study are (i) to evaluate the loop security of standard sliding knots when using different types of high-strength suture materials and (ii) to compare the loop security of a new sliding knot (Chula knot) to other standard sliding knots. Four configurations of sliding locking knots (Weston, SMC, Tennessee and Chula knots) were tied using three commonly used suture materials: MagnumWire, Hi-Fi, and FiberWire. The suture loops were mounted on two metallic hooks of the universal testing machine. Then, the suture loop was pulled apart until failure. The Weston knot demonstrated the greatest load to failure in all suture materials. By using MagnumWire, the load to failure was as follow: Weston 53.2 N, Chula 48.8 N, SMC 39.2 N, and Tennessee 29.3 N. By using Hi-Fi, the load to failure was as follow: Weston 58.8 N, Chula 51.5 N, SMC 38.1 N, and Tennessee 28.7 N. By using FiberWire, the load to failure was as follow: Weston 38.8 N, Chula 29.7 N, SMC 23.2 N, and Tennessee 21.9 N. Weston knot has the highest loop security in all suture materials. Weston-HiFi combination demonstrate the strongest loop security. Conversely, the weakest combination is Tennessee-FiberWire. Chula knot has similar properties to other commonly used arthroscopic sliding knots. Our findings indicate that surgeons should be careful in selecting proper knot-suture combinations.