Abstract
Bidirectional barbed sutures (BBSs) have recently been investigated in total knee
arthroplasty (TKA). The contrasting results from the scarce literature suggest that
BBSs are safe, save time and money, and give results comparable to traditional sutures.
The purpose of the study is to test the real effect of BBSs on closure time in TKA
and assess the functional results as well as the complications related to them. It
was a randomized controlled trial. Eighty-five patients undergoing primary TKA were
assigned to receive traditional closure with Vicryl (V-group) or with BBSs (Q-group).
The exclusion criteria were significant coronal deformity, flexion contracture, or
the need for stem and/or augmentation. The closure time for the capsule and that for
the subcutaneous layer were registered separately. Intraoperative incidences were
recorded. The follow-up was up to 1 month, during which the range of motion (ROM),
superficial or deep infection, and wound dehiscence were assessed. There was a significant
reduction in the capsule layer (27 seconds; p = 0.02) and global time closure (51 seconds; p = 0.01) in the Q-group. No differences were found in the subcutaneous layer (24 seconds;
p = 0.055). There were more intraoperative suture breakages in the Q-group, mainly
in the subcutaneous layer (p < 0.001). No differences in terms of dehiscence, infection, and ROM were observed
at the 1-month follow-up. BBSs allow for slightly faster wound closure than Vicryl
during a TKA. However, the differences observed have minimal clinical repercussions.
Moreover, no differences in the infection rate (deep or superficial), dehiscence,
or ROM were found.
Keywords
barbed suture - total knee arthroplasty - closure time
