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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. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1804-1807, 2016.

Background Silk fibroin (SF) can be processed into a hydrogel. SF/collagen hydrogel may be a suitable biomaterial for bone tissue engineering. Objectives To investigate in vitro biocompatibility and osteogenic potential of encapsulated rat bone marrow-derived mesenchymal stem cells (rat MSCs) in an injectable Thai SF/collagen hydrogel induced by oleic acid–poloxamer 188 surfactant mixture in an in vitro pilot study. Methods Rat MSCs were encapsulated in 3 groups of hydrogel scaffolds (SF, SF with 0.05% collagen [SF/0.05C], and SF with 0.1% collagen [SF/0.1C]) and cultured in a growth medium and an osteogenic induction medium. DNA, alkaline phosphatase (ALP) activity, and calcium were assayed at periodically for up to 5 weeks. After 6 weeks of culture the cells were analyzed by scanning electron microscopy and energy dispersive spectroscopy. Results Although SF hydrogel with collagen seems to have less efficiency to encapsulate rat MSCs, their plateau phase growth in all hydrogels was comparable. Inability to maintain cell viability as cell populations declined over 1–5 days was observed. Cell numbers then plateaued and were maintained until day 14 of culture. ALP activity and calcium content of rat MSCs in SF/collagen hydrogels were highest at day 21. An enhancing effect of collagen combined with the hydrogel was observed for proliferation and matrix formation; however, benefits of the combination on osteogenic differentiation and biomineralization are as yet unclear. Conclusion Rat MSCs in SF and SF/collagen hydrogels showed osteogenic differentiation. Accordingly, these hydrogels may serve as promising scaffolds for bone tissue engineering.

Meniscus root tear leads to circumferential hoop tension loss and increases femorotibial contact force, which causes irreversible cartilage degeneration. Biomechanical studies have shown that meniscus root repair provides better femorotibial contact force than meniscectomy. Many techniques for meniscus root repair have been published in recent years. The soft suture anchor is widely used in the glenoid labral repair. It is a small low-profile soft anchor. This article presents a new and simple technique of lateral meniscus root repair using the small soft anchor, which results in an anatomic and more vertical anchor position. It avoids instrument-related complications, such as cartilage delamination, material reaction, metal retention, and hard suture anchor pullout.

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Acute partial injury of the anterior cruciate ligament (ACL) is a challenging condition without a standard treatment. Although ACL reconstruction provided a better outcome previously, recent studies have shown that preserving the ACL stump yields promising results in terms of better vascularization, proprioception, and ligamentization. ACL augmentation is becoming more popular. Therefore, we propose a technique to augment an acute partial ACL injury with synthetic suture material to stabilize the unstable cruciate ligament. The suture material acts as a structural tie for ACL healing without any need for external immobilization. This technique is beneficial in preserving the natural ACL stump and autograft, creating a narrow bone tunnel, and providing a good cosmetic outcome.

There are many types of sliding locking knots used in arthroscopic surgery. Each type has its advantages and disadvantages. This technical note describes a new sliding locking knot, the Chula knot. This knot has been used for arthroscopic shoulder surgery in more than 500 cases at our hospital. The Chula knot has a special property in that it can be unfastened and retightened in case of premature locking and unintended loop loosening. This retensioning ability cannot be found in other configurations of arthroscopic knots. The Chula knot also has other benefits: It has high ultimate tensile strength and is easy to tie.

A SLAP lesion can be found with a concomitant spinoglenoid notch cyst. The cyst can cause suprascapular nerve compression, resulting in shoulder pain and weakness of external rotation. Their management varies from conservative treatment to operative treatment. Cyst decompression through the labral tear is our preferred treatment. Previous studies demonstrated a good result after arthroscopic decompression of the cyst through the labral tear combined with SLAP repair. Many surgeons usually use 3 portals to perform this procedure. However, we prefer to use only 2 portals, 1 anterior viewing portal and 1 posterior working portal. This strategy is more time and cost efficient. The patient is positioned in lateral decubitus. The SLAP lesion is demonstrated by using a probe. Tissue elevator is inserted into the labral lesion to penetrate into the cyst wall. A soft anchor is placed. A birdbeak suture passer penetrates the posterior labrum. Then knot tying is done. The advantages of this single working portal technique are short operative time, a decreased risk of iatrogenic rotator cuff injury from accessory anterolateral portal or posterior labral injury from posterolateral portal, and avoiding unnecessary superior capsule incision for cyst exposure.