Revo Knot
courtesy of Linvatec, UK
1. Thread one suture strand through the tip of the loop handle knot pusher. This strand is designated as "the post." Attach a clamp to the post four inches from the cannula. Slide the knot pusher down the length of the post to ensure that no twists or obstructing soft tissues are present.
2. Pass the other strand under, then over the post to form the first half-hitch. Using alternating tension on each strand, "walk" the half-hitch down to the soft tissue and tighten it (do not slide the half-hitch) through the tissue like a slip knot).
3. In the same manner as before, tie a second half-hitch (pass the other strand under, then over the post). Walk the half-hitch down to the soft tissue and tighten it.
4. In the opposite direction to the first and second throws, tie a third half-hitch around the post (pass the other strand over, then under the post). Walk the half-hitch down to the soft tissue and tighten it.
5. Change the clamp and knot pusher to the other suture strand. This strand is designated as the "new post." Pass the other strand under, then over the new post to form a forth half-hitch. Walk the half-hitch down to the soft tissue and tighten it.
6. Relax the tension on both suture strands and advance the knot pusher past the knot. Then tighten both strands in order to lock the knot. This technique is called "past-pointing."
7. Change the clamp and knot pusher back to the original post. Pass the other strand over, then under the post to form a fifth half-hitch. Walk the half-hitch down to the soft tissue and past-point to secure the knot.
8. Cut away the excess suture three to four millimeters from the knot.
