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The Arthroscopic Square Knot: Fiction or Fact?
Steven M. Hammerman, MD, Hussein Elkousy, MD, T. Bradley Edwards, MD, Daniel P. O'Connor, PhD, and Gary M. Gartsman, MD
Dr. Hammerman is Assistant Surgeon, Dr. Elkousy is Staff Surgeon, Dr. Edwards is Staff Surgeon, Dr. O'Connor is Research Director, and Dr. Gartsman is Staff Surgeon, Texas Orthopedic Hospital, Houston, Texas, and Fondren Orthopedic Group, Houston, Texas.
The square knot is the gold standard for open surgical knot tying. One criticism of arthroscopic shoulder surgery is that arthroscopic knots are not as secure as square knots tied during traditional open surgery. In this brief technical note, we describe a simple technique for tying arthroscopic square knots that the senior members of our group have been using in clinical practice for several years with successful results.