Use of a Safety Clamp When Performing Arthroscopic Knot Tying Preserves the Suture When It Is Placed Under Excessive Tension

The purpose of this study was to compare the location of the suture breakage between tying by hand vs with a safety clamp, needle driver. FiberWire No. 2 and 2-0 (Arthrex, Naples, Florida) were fastened onto the hook attachment of the digital force gauge. Sutures were placed under excessive strain using a hand tying technique vs a safety clamp, or instrument tying. Peak forces at which the sutures failed under tension along with locations of the suture breakage, measured from the site of the knot, were recorded. For FiberWire No. 2, the mean load to failure was 142.60±2.33 N for hand tying and 78.79±1.97 N for the safety clamp (P<.0001). For FiberWire 2-0, the mean load to failure was 62.98±4.90 N for hand tying and 34.43±2.46 N for the safety clamp (P<.0001). For FiberWire No. 2, the mean location of suture breakage was 0 cm, at the site of the knot, for hand tying and at the clamping point (10.45±0.34 cm from the knot) for the safety clamp (P<.0001). For FiberWire 2-0, the mean location of suture breakage was 0 cm, at the site of the knot, for hand tying and at the clamping point (10.47±0.22 cm from the knot) for the safety clamp (P<.0001). Use of a safety clamp while mastering arthroscopic suture technique preserves the suture knot when placed under excessive tension. [Orthopedics. 2019; 42(1):e25-e28.].