Knotless Fixation Is Stronger and Less Variable Than Knotted Constructs in Securing a Suture Loop.

Background: Historically, tendon-to-bone fixation has relied on knot tying. However, considerable variability exists in knot-tying strength among surgeons.

Purpose/hypothesis: The purpose of this study was to compare the biomechanical properties of knotted and knotless fixation and to evaluate variability among surgeons.

The resistance to failure of spring ligament reconstruction.

Introduction: The spring ligament (SL) is increasingly recognised as the major structure that fails in acquired adult flatfoot deformity (AAFD). This is the first study that demonstrates integrity of repair of the SL.

Patients And Methods: Six pairs of fresh frozen cadavers were setup in a standardised fashion with ankle in plantargrade (mean age 59 years, BMI 25).