Presented by:
Mary Lloyd Ireland
Professor
Dept. of Orthopaedic Surgery and Sports Medicine
University of Kentucky
Lexington KY
www.marylloydireland.com
0:00 Introduction
0:37 Knots
1:12 “Knot-Tying and Suture-Passing Techniques,”
1:41 Suture Passage: Tissue Penetrators
•Directly grasp the suture through the tissue
•Antegrade or Retrograde technique
•Get the ideal angle for suture passage
•Be careful with manipulating the instruments to avoid damage to labrum or articular cartilage
2:25 Varying Angles of the Bird Beak Instrument
2:54 Suture Passage Relay Technique
•Cannulated needle devices pass through the tissue
•The suture lasso is retrieved through a working portal
•Grasp the lasso and suture in one pass
•Use clear plastic cannulas
•Pass the suture in through the lasso
•If simple suture, tie now; if mattress suture, pass next limb, then tie
3:53 Suture Lasso Device Picture
4:47 Knot-Tying Video
7:11 Half-Hitches
8:00 Nicky's Knot
10:12 SMC Knot
11:22 Duncan Loop
12:36 Knot Pushing Basics
Throwing Half Hitches
13:12 Knot Pushing Basic Demonstration
13:36 Non-Sliding Knot
15:18 Flipping Posts
17:13 Past Pointing
17:41 Grinner Knot & Needle Knot
18:22 Knot Types
•Non-Sliding
•Use if the knot will not slide
•Series of half-hitches, loop limb is tied around the post
•Alternate loop and post limbs
•Change direction of suture throws to increase knot security
19:16 Knot Types (cont)
•Sliding
•Use if the knot will slide
•Have an internal locking mechanism providing increased loop security while tying
•Locking mechanism one-way ratchet effect, or self-locking effect
•Categorized depending on location of wrapping limb relative to the surgeon
•Proximal - closer to the surgeon (Nicky’s knot)
•Middle - (Tennessee Slider, Samsung Medical Center)
•Distal - (Weston, Roeder, Duncan)
20:20 Weston Knot
21:38 SMC Knot
23:40 Duncan Loop
Sliding Non-Locking Knot
25:06 Secrets to Success:
•Practice, practice, practice!!
•Respect the sutures; they WILL tangle
25:43 The End . . .Thank You!
Негізгі бет 573 Knot-Tying Intern Arthroscopy Course
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