Bidirectional knotless barbed sutures during primary total knee arthroplasty: effective solution or new problem?

Abstract

The use of bidirectional knotless barbed sutures in TKA reduces the time of surgery, does not affect the volume of hidden blood loss or PPI occurrence.

Barbed Sutures in Total Knee Arthroplasty: A Meta-analysis of Randomized-Controlled Trials

“…Finally, we identified 1,472 TKAs (1,270 patients) assessed in 12 RCTs. 1,4,[17][18][19][20][21][22][23][24][25]29 The detailed baseline characteristics and general intervention information are presented in ►Table 1. All the articles were published in English, Chinese, and Russian between the years 2012 and August 2019.…”

“…Some studies evaluating wound closures using KBS and KTS techniques have supported no increase in wound-related complications with KBS. 1,4,[17][18][19][20][21][22][23][24][25] However, other authors have suggested an increased rate of complications. [14][15][16] Campbell et al 14 found that wound close with KBS showed a higher rate of infection and overall closure-related complications and they thought doctors should avoid using barbed suture for superficial closure after knee arthroplasty.…”

“…[14][15][16] However, more reports have associated KBS wound closure with shorter total wound closure time, similar or fewer wound-related complications compared with KTS. 1,4,[17][18][19][20][21][22][23][24][25] To date, there is a limited high-quality data evaluating wound closure with KBS and KTS in TKA. Three meta-analyses have been performed, but all included several nonrandomized studies that are potentially subject to selection bias.…”

Effect of barbed versus standard sutures on wound complications in total knee arthroplasty: A meta‐analysis

“…Zaruby et al argue that barbed suture are strong and safe 32 . Chugaev et al argue that barbed suture are less time‐consuming and safer than traditional suture 33 . These are all points in favour of barbed suture.…”

A comparison between barbed suture and conventional suture in total knee arthroplasty: a systematic review and meta-analysis

“…Zaruby et al [ 23 ] augured that bidirectional barbed suture was safe and effective, and its strength and surrounding tissue reactions were comparable to those of absorbable suture. Chugaev et al [ 24 ] indicated that closure of joint capsule and subcutaneous adipose tissue with bidirectional knotless barbed sutures in primary TKA was safe and time-saving, because it did not cause occult blood loss or the occurrence of infection. Shermak et al [ 25 ] found barbed sutures were associated with greater difficulty in the healing of the knee extensor mechanism and higher complication rates when fascia and subcutaneous tissues were sutured.…”