• Arch Orthop Trauma Surg · May 2024

    Randomized Controlled Trial

    Knotless suture in revision total joint arthroplasty: a prospective randomized controlled trial.

    • Itay Ashkenazi, Walter D Sobba, Jessica S Morton, Thomas Bieganowski, Ittai Shichman, and Ran Schwarzkopf.
    • Department of Orthopaedic Surgery, NYU Langone Health, NewYork, NY, USA.
    • Arch Orthop Trauma Surg. 2024 May 1; 144 (5): 220722122207-2212.

    IntroductionThe use of barbed sutures for wound closure in primary total joint arthroplasty (TJA) has been shown to be effective and safe. However, their effectiveness and safety in revision TJA procedures has not been thoroughly studied. This study aims to evaluate the efficacy and safety of using barbed suture closure in revision TJA setting.MethodsA total of 80 patients undergoing revision TJA between September 2020 and November 2022 were included in this randomized controlled trial study. Following informed consent, patients were computer-randomized to the treatment arm (barbed suture wound closure) or to the control arm (conventional wound closure). Closure duration, closure rate, number of sutures used and wound related outcomes including complication rates and Patient and Observer Scar Assessment Scale (POSAS) score were compared between groups.ResultsThe use of barbed sutures decreased closure time by 6 min (30.1 vs. 36.1 min, P = 0.008) with a higher wound closure rate (6.5 vs. 5.5 mm/minute, P = 0.013). Additionally, the number of sutures used for wound closure in the barbed group was significantly lower than in the control group (6.2 vs. 10.1, respectively, P < 0.001). There were no significant differences in the rate of postoperative wound complications (P = 0.556) or patient and observer POSAS scores (P = 0.211, P = 297, respectively) between the two groups at 3-month follow-up.ConclusionClosure of revision TJA surgical wound utilizing barbed sutures reduced closure time and the number of needles handled by operative staff, with no significant increase in intra- or post-operative complications rate when compared to traditional closure technique.Level Of EvidenceI.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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