Surgeon's Knot - Arthroscopic Knot Tying

See Reverse Flipping Technique to secure the knot

Presented by
Aony Zacharias, MD
PGY-4, Department of Orthopaedic Surgery and Sports Medicine
University of Kentucky College of Medicine

Mary Lloyd Ireland, MD
Professor, Department of Orthopaedic Surgery and Sports Medicine
University of Kentucky College of Medicine

Arthroscopic Knot Tying
To be Published in
Cole & Chahla: Surgical Techniques of the Shoulder, Elbow, and Knee in Sports Medicine

Surgical technique
The ambidextrous surgeon's knot: an alternate way to tie the surgeon's knot
Pankaj K. Jha, Anthony G. Barabas, and Hemant Sharma

The surgeon's knot is a secure way to tie sutures or ligate critical vessels. It is particularly useful when using nonabsorbable monofilament sutures. Another advantage of this knot is to use the double first throw to keep it from slipping when approximating tissues under tension. It is extremely useful in tying drains whose surfaces are slippery and can lead to slippage and thus loosening of traditional knots.

The surgeon's knot is a surgical knot and is a simple modification to the reef knot. It adds an extra twist when tying the first throw, forming a double overhand knot. The additional turn provides more friction and can reduce loosening while the second half of the knot is tied. This knot is commonly used by surgeons in situations where it is important to maintain tension on a suture, giving it its name.

Like the reef knot, the surgeon's knot capsizes and fails if one of the working ends is pulled away from the standing end closest to it.