Barbed sutures reduce arthrotomy closure duration compared to interrupted conventional sutures for total knee arthroplasty: a randomized controlled trial

• Published in: Musculoskeletal surgery Vol. 105; no. 3; pp. 275 - 281
• Main Authors: Sundaram, K., Warren, J. A., Klika, A., Piuzzi, N. S., Mont, M. A., Krebs, V.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-12-2021; Springer; Springer Nature B.V
• Subjects: Comparative analysis; Health aspects; Joint replacement surgery; Knee; Medicine; Medicine & Public Health; Original Article; Orthopedics; Surgical Orthopedics; Surgical outcomes; Sutures; Wounds and injuries; Total knee arthroplasty; Closure; Total knee replacement; Barbed suture; Wound closure; TKR; TKA
• ISSN: 2035-5106; 2035-5114
• DOI: 10.1007/s12306-020-00654-y

Background
The broad aim of this study was to compare the safety and efficacy of using barbed sutures versus standard-of-care sutures for closure of arthrotomy during total knee arthroplasty. Specifically, we compared the duration of arthrotomy closure, the number of sutures utilized for arthrotomy closure, and 90-day outcomes, including wound-related readmission, reoperation, and complications.
Materials and methods
A total of 60 patients undergoing primary total knee arthroplasty were enrolled in a prospective, blinded trial and randomized to receive either running closure of the arthrotomy with barbed sutures (
n
 = 30) or interrupted closure with standard-of-care sutures (
n
 = 30).
Results
Arthrotomy closure time was significantly shorter in the barbed suture group (3 min ± 2 min) versus the standard-of-care group (13 min ± 5 min,
p
 < 0.001). The average suture utilization for arthrotomy closure was 1 suture (range 1–2) versus 3 sutures (range 2–4) in the standard-of-care group (
p
 < 0.001). The overall number of wound-related complications in the barbed suture group was 3/30 (10%) versus 3/30 (10%) in the standard-of-care group (
p
 = 1.00). There was one dehiscence 1/30 (3%) in the standard-of-care group versus zero in the barbed suture group (
p
 = 1.00). The rate of superficial surgical site infection was 1/30 (3%) in barbed suture versus zero in the standard-of-care groups (
p
 = 1.00).
Conclusion
These results suggest barbed suture utilization may be faster and more resource-efficient than the use of standard-of-care sutures for arthrotomy closure in primary total knee arthroplasty without increased complications.
ClinicalTrials.gov Identifier
NCT03285529