A portable tensiometer for assessing knot-tying technique

The purpose of this study was to determine the influence of orthopedic surgeons' tying techniques on knot security using 2-0 and 4-0 monofilament and multifilament nylon sutures. Using an Instron® Tensile Tester and a portable tensiometer, knot security was achieved with these sutures using four-throw square knots (1 = 1 = 1 = 1). After didactic and psychomotor skill training, medical students were taught to construct the four-throw square knot using either a two-hand tie or an instrument tie. Using the portable tensiometer, their knot-tying techniques were judged to be superior to those used by orthopedic surgeons. The orthopedic surgeon's faulty technique can easily be corrected by didactic information and psychomotor skill training.