The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study
Abstract Background Wound closure is one of the crucial aspects of total knee arthroplasty (TKA) for patients who perform high-flexion activities of daily living, because the joint capsule is highly stretched and integrity of the arthrotomy closure must be maintained. Watertightness of the knee join...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-018-1035-3 |
| _version_ | 1811185087869353984 |
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| author | Shu Kobayashi Yasuo Niki Kengo Harato Kazuhiko Udagawa Morio Matsumoto Masaya Nakamura |
| author_facet | Shu Kobayashi Yasuo Niki Kengo Harato Kazuhiko Udagawa Morio Matsumoto Masaya Nakamura |
| author_sort | Shu Kobayashi |
| collection | DOAJ |
| description | Abstract Background Wound closure is one of the crucial aspects of total knee arthroplasty (TKA) for patients who perform high-flexion activities of daily living, because the joint capsule is highly stretched and integrity of the arthrotomy closure must be maintained. Watertightness of the knee joint is a different aspect of the repair integrity of arthrotomy closure and is being noticed with increasing usage of the drain clamp method for blood management after TKA. Recently, the barbed knotless suture has been growing in popularity as a strong, secure closure appropriate for high-tension areas, such as the fascia and joint capsule. The purpose of this study was to compare the barbed knotless suture with simple interrupted suture in cadaveric knees. Methods Nine fresh-frozen cadaveric lower extremities were used. After placing a parapatellar incision and setting a closed suction drain, arthrotomies were closed randomly using three suture materials: simple interrupted absorbable suture (No. 0 PDS, group C); or a single running knotless barbed suture Stratafix with 8N (group BS-8N) or 15N (group BS-15N) of tension. After arthrotomy closure, saline was injected in a retrograde manner into the joint through a drain until saline started to leak from the joint. Peak values for intra-articular pressure and infusion volume in each group were recorded and compared. Results Mean infusion volumes were 13.0 ± 7.2 ml, 38.6 ± 10.7 ml, and 5.1 ± 2.5 ml in groups BS-8N, BS-15N, and C, respectively. Mean intra-articular pressures were 0.67 ± 0.47 kPa, 9.44 ± 4.55 kPa, and 0.56 ± 0.44 kPa in groups BS-8N, BS-15N, and C, respectively. Infusion volume and joint internal pressure were significantly higher in group BS-15N than in groups BS-8N (p = 0.008) or C (p = 0.04). Conclusions Barbed suture with 15N appears appropriate for maintaining maximal watertightness after knee joint capsule closure, offering successful drain clamping, higher resistance to early mobilization protocols, and subsequent achievement of early deep knee flexion after TKA. |
| first_indexed | 2024-04-11T13:24:46Z |
| format | Article |
| id | doaj.art-6f9f48ee0810435191e46b4ca0b9dc07 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:24:46Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-6f9f48ee0810435191e46b4ca0b9dc072022-12-22T04:22:07ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-12-011311510.1186/s13018-018-1035-3The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric studyShu Kobayashi0Yasuo Niki1Kengo Harato2Kazuhiko Udagawa3Morio Matsumoto4Masaya Nakamura5Department of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityAbstract Background Wound closure is one of the crucial aspects of total knee arthroplasty (TKA) for patients who perform high-flexion activities of daily living, because the joint capsule is highly stretched and integrity of the arthrotomy closure must be maintained. Watertightness of the knee joint is a different aspect of the repair integrity of arthrotomy closure and is being noticed with increasing usage of the drain clamp method for blood management after TKA. Recently, the barbed knotless suture has been growing in popularity as a strong, secure closure appropriate for high-tension areas, such as the fascia and joint capsule. The purpose of this study was to compare the barbed knotless suture with simple interrupted suture in cadaveric knees. Methods Nine fresh-frozen cadaveric lower extremities were used. After placing a parapatellar incision and setting a closed suction drain, arthrotomies were closed randomly using three suture materials: simple interrupted absorbable suture (No. 0 PDS, group C); or a single running knotless barbed suture Stratafix with 8N (group BS-8N) or 15N (group BS-15N) of tension. After arthrotomy closure, saline was injected in a retrograde manner into the joint through a drain until saline started to leak from the joint. Peak values for intra-articular pressure and infusion volume in each group were recorded and compared. Results Mean infusion volumes were 13.0 ± 7.2 ml, 38.6 ± 10.7 ml, and 5.1 ± 2.5 ml in groups BS-8N, BS-15N, and C, respectively. Mean intra-articular pressures were 0.67 ± 0.47 kPa, 9.44 ± 4.55 kPa, and 0.56 ± 0.44 kPa in groups BS-8N, BS-15N, and C, respectively. Infusion volume and joint internal pressure were significantly higher in group BS-15N than in groups BS-8N (p = 0.008) or C (p = 0.04). Conclusions Barbed suture with 15N appears appropriate for maintaining maximal watertightness after knee joint capsule closure, offering successful drain clamping, higher resistance to early mobilization protocols, and subsequent achievement of early deep knee flexion after TKA.http://link.springer.com/article/10.1186/s13018-018-1035-3Barbed sutureTotal knee arthroplastyWatertightnessArthrotomy closure |
| spellingShingle | Shu Kobayashi Yasuo Niki Kengo Harato Kazuhiko Udagawa Morio Matsumoto Masaya Nakamura The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study Journal of Orthopaedic Surgery and Research Barbed suture Total knee arthroplasty Watertightness Arthrotomy closure |
| title | The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study |
| title_full | The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study |
| title_fullStr | The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study |
| title_full_unstemmed | The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study |
| title_short | The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study |
| title_sort | effects of barbed suture on watertightness after knee arthrotomy closure a cadaveric study |
| topic | Barbed suture Total knee arthroplasty Watertightness Arthrotomy closure |
| url | http://link.springer.com/article/10.1186/s13018-018-1035-3 |
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