Reverse Flipping Technique: An Alternate Approach to Tie Reversing Half-Hitches on Alternating Posts  Alexander C.M. Chong, M.S.A.E., M.S.M.E., Daniel J. Prohaska, M.D., Ryan C. Pate, M.D.  Arthroscopy Techniques  Volume 5, Issue 2, Pages e403-e405 (April 2016) DOI: 10.1016/j.eats.2016.01.012 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Reverse flipping technique steps. (A) The initial base knot of the surgeon's preference is slid down to the tissue using a knot pusher on the post limb; the first half-hitch is formed while maintaining tension on the post suture limb, which is then pushed down onto the base knot using the knot pusher until the loop seats on the main knot. (B) The half-hitch is tightened by using the over-pointing technique. (C) Tension then deliberately applies to the loop suture limb until a “flip” occurs. (D) The half-hitch is retightened again by using the past-pointing technique. (E) The second half-hitch is placed over the post suture limb again, but then the post switches by increasing tension on the loop suture limb. (F) The second half-hitch is tightened by using the past-pointing technique. (G) Tension then deliberately applies to the post limb until a “flip” occurs. (H) The half-hitch is retightened again by using the over-pointing technique. (I) The last half-hitch is then placed over the post suture limb again while maintaining tension on the post limb. (J) The half-hitch is retightened again by using the over-pointing technique. (K) Tension then deliberately applies to the loop limb until a “flip” occurs. (L) The half-hitch is retightened again by using the past-pointing technique. Arthroscopy Techniques 2016 5, e403-e405DOI: (10.1016/j.eats.2016.01.012) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions