Comparison of Three Suture Materials in Capsular Closure Closure Time and Wound Complications Following Knee Arthroplasty.

BACKGROUND
Watertight capsular closure in knee arthro- plasty is desirable in order to achieve a good functional outcome. Barbed knotless sutures are being increasingly used in wound closure following knee arthroplasty. The prior studies have compared barbed sutures with either VICRYL® or Ethibond for closure, while none had compared all the three in a single setting in terms of closure time, needle stick injuries, postoperative complications, and functional outcome.


PATIENTS AND METHODS
One hundred and forty-three subjects of unilateral knee arthroplasty were screened for eligibility in the prospective randomized controlled trial. One hundred and twenty patients fulfilled the inclusion criteria and were randomized into three groups to undergo capsular closure with barbed sutures, VICRYL, or Ethibond.


RESULTS
The wound closure was fastest with barbed su- tures followed by VICRYL and Ethibond (10.4 ± 4.1; 15.4 ± 4.7; 17.2 ± 3.8 minutes; p < 0.001). There were seven needle stick injuries in the Ethibond group followed by three in the VICRYL group and none in the barbed suture group. The Knee Society Scores and wound related complications were comparable in all the three groups.


CONCLUSION
Barbed suture, VICRYL, and Ethibond are equally good in the capsular closure following knee arthro- plasty. The faster wound closure time achieved may not be clinically relevant in the short term.