The impact of novel anchored barbed suture for capsular closure on hospital length of stay after total knee arthroplasty: a retrospective cohort study

Abstract

Objective The aim was to evaluate whether using novel anchored barded suture for capsular closure can further shorten the length of stay following primary total knee arthroplasty (TKA) within existed enhanced recovery after surgery (ERAS) protocol in osteoarthritis patients. Methods A retrospective cohort study was conducted among osteoarthritis patients aged 18 to 80 years without major comorbidities who underwent primary unilateral TKA between January 2018 and December 2019 was conducted. The capsular closure techniques, interventions for ERAS, operation time and length of stay were collected via hospital electronic information system. Propensity-score matching was used to compensate for the difference in interventions for ERAS and patient characteristics. Subgroup comparison of patients treated under normal ERAS protocol was performed. Results Included were 315 patients with capsular closure by barded suture and 397 patients with interrupted capsular closure by traditional suture. Patients’ characteristics and interventions for ERAS were balanced after propensity-score matching. The average postoperative length of stay in barded suture group was shorter than the compared group (2.10 ± 0.57 vs. 2.33 ± 0.80 days, p = 0.004), and with a significantly higher proportion of patients discharging within 2 days post procedure (88.0% vs. 70.7%, p < 0.001). The operation time for patients with barded suture closure was shorter compared to interrupted closure technique (100.90 ± 16.59 vs. 105.52 ± 18.47 min, p = 0.004). Subgroup analysis of patients treated under different levels ERAS protocol showed comparable results. Conclusion The use of barded suture for capsular closure was associated with shorter length of stay after TKA compared to traditional suture, suggesting that barded suturing technique could be one effective intervention for ERAS.