Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial

Abstract Background Wound closure is key to prevent infection, facilitate immediate rehabilitation and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims to compare barbed and traditional sutures wound closure time and cost in primary total knee arthroplasty. Methods One hundred and nine knees were randomized into either barbed or traditional group. Synthetic absorbable sutures (Vicryl, Ethicon Inc, United States) and bidirectional barbed sutures (Stratafix, Ethicon Inc, United States) were used. Arthrotomy and subcutaneous wound closure time, wound complications, and rehabilitation parameters in terms of range of motion (ROM) and Knee Society Score (KSS) were compared. Patients were followed up to 3 months. Results Traditional sutures had significantly more positive leak tests (10 versus 2, p-value