Knot integrity with nonidentical and parallel sliding knots

Objective The study was performed to test the knot integrity of parallel and nonidentical sliding knots with the use of monofilament suture. Study design We investigated the proportion of parallel sliding knots that become untied compared with nonidentical sliding knots in four different monofilament suture configurations: group A, 6 throws, 0-0 gauge; group B, 10 throws, 0-0 gauge; group C, 6 throws, 2-0 gauge; group D, 10 throws, 2-0 gauge. Each combination was tested 20 times, for a total of 160 knots. Results The nonidentical sliding knot untied 40% of the time in group A compared with 0% for the parallel knot (P = .003). In the other 6-throw group, group C, 45% of the nonidentical knots became untied compared with 0% of the parallel knots (P = .001). There were no significant differences in the proportions of untying for each knot type in the 10-throw groups. Conclusion Parallel sliding knots demonstrate superior knot integrity compared with nonidentical sliding knots with monofilament suture. The addition of throws to the nonidentical knot improves its knot security.