A knot pusher usable for pushing various types of knots including sliding knots and overhand knots formed from a suture, two limbs of the suture extending from the knot, the knot pusher comprising: a distal head defining top and bottom walls terminating in a distal knot pushing surface ; at least two side grooves defined between said top and bottom walls and extending proximally from said knot pushing surface , each of said side grooves operable to receive one of the limbs of suture to facilitate advancement of an overhand knot; at least one suture guide being defined by said top and bottom walls and defining a guiding channel that is in communication with one of the side grooves for guiding the one of the limbs of suture into said one of the side grooves ; and wherein the knot pusher further comprises a top wall suture receiving element comprising a groove formed within said top wall for receiving one of the two limbs of the suture during advancement of said distal head to facilitate advancement of a sliding knot; at least one side groove suture retaining element , , , , , , for retaining one of the limbs of suture within said one of said side grooves, and said at least one suture guide comprising a suture containment means that defines a barrier for co-operating with the at least one side groove suture retaining element , , , , , , to retain said one of the limbs of the suture within said one of the side grooves ; characterized in that said suture containment means comprises an extending portion of one of said top and bottom walls that extends about the at least one side groove suture retaining element , , , , , , forming a barrier to encompass the at least one side groove suture retaining element , , , , , , , therein to prevent said one of the limbs of suture from getting behind the one of said top and bottom walls forming the extending portion. a distal head defining top and bottom walls terminating in a distal knot pushing surface ; at least two side grooves defined between said top and bottom walls and extending proximally from said knot pushing surface , each of said side grooves operable to receive one of the limbs of suture to facilitate advancement of an overhand knot; at least one suture guide being defined by said top and bottom walls and defining a guiding channel that is in communication with one of the side grooves for guiding the one of the limbs of suture into said one of the side grooves ; and wherein the knot pusher further comprises a top wall suture receiving element comprising a groove formed within said top wall for receiving one of the two limbs of the suture during advancement of said distal head to facilitate advancement of a sliding knot; at least one side groove suture retaining element , , , , , , for retaining one of the limbs of suture within said one of said side grooves, and said at least one suture guide comprising a suture containment means that defines a barrier for co-operating with the at least one side groove suture retaining element , , , , , , to retain said one of the limbs of the suture within said one of the side grooves ; characterized in that said suture containment means comprises an extending portion of one of said top and bottom walls that extends about the at least one side groove suture retaining element , , , , , , forming a barrier to encompass the at least one side groove suture retaining element , , , , , , , therein to prevent said one of the limbs of suture from getting behind the one of said top and bottom walls forming the extending portion. <EOS>