AANA Lab Course 915 - Foundations in Arthroscopy-AANA Knot Tying Lab-Howard J. Sweeney M.D.

AANA Knot Tying Lab-Howard J. Sweeney M.D.

Pdf Summary

The AANA Knot Tying Lab, led by Dr. Howard J. Sweeney, is designed to teach essential arthroscopic knot-tying skills. The lab utilizes the F.A.S.T. platform and an interactive tablet-based program with step-by-step instructions for practicing various knots. Initially, participants remove the dome component from the F.A.S.T. platform and begin by tying knots with rope on hooks before moving to suture tying with a knot pusher.<br /><br />The program categorizes arthroscopic knots into three types: sliding (e.g., Duncan Loop), sliding-locking (e.g., Weston), and non-sliding (e.g., Revo-SCOI). All knots require reinforcement with a specific "Harryman" knot, composed of three alternating half-hitches using alternating posts.<br /><br />Key pre-knot tying concepts include understanding the "post limb"—the limb where loops are slid down, typically the limb farthest from the glenoid center—and the "loop limb," which forms loops around the post limb. To ensure knot success, the post limb must slide smoothly, the initial post limb should be less than half the length of the loop limb, and a knot pusher and hemostat should be placed on the initial post limb to prevent twists.<br /><br />Knot tying progresses from rope to suture using the knot pusher, eventually tying through a cannula or portal in the FAST module. Knots are tested using a Knot Tester, which measures loop size and applies 15 pounds of pressure for 15 seconds. Loops stretching three millimeters or more indicate knot failure. Common problems include excessive slack and failure to alternate posts and loops, both contributing to knot failure.<br /><br />Participants are encouraged to work carefully and deliberately, emphasizing accuracy over speed, and to back up all knots with the Harryman half-hitches for security. The interactive tablet program supports learning with instructional videos like the Duncan Loop demonstration for thorough practice.

Keywords

AANA Knot Tying Lab

arthroscopic knot-tying

F.A.S.T. platform

interactive tablet program

Duncan Loop

Weston knot

Revo-SCOI knot

Harryman knot

post limb and loop limb

knot testing and failure criteria