Water-tight knee arthrotomy closure: comparison of a novel single bidirectional barbed self-retaining running suture versus conventional interrupted sutures

• Published in: The Journal of knee surgery Vol. 24; no. 1; p. 55
• Main Authors: Nett, Michael, Avelar, Rui, Sheehan, Michael, Cushner, Fred
• Format: Journal Article
• Language: English
• Published: Germany 01.03.2011
• Subjects: Absorbable Implants; Arthroplasty, Replacement, Knee; Cadaver; Case-Control Studies; Exudates and Transudates; Humans; Rupture; Suture Techniques; Sutures
• ISSN: 1538-8506
• DOI: 10.1055/s-0031-1275400

Standard medial parapatellar arthrotomies of 10 cadaveric knees were closed with either conventional interrupted absorbable sutures (control group, mean of 19.4 sutures) or a single running knotless bidirectional barbed absorbable suture (experimental group). Water-tightness of the arthrotomy closure was compared by simulating a tense hemarthrosis and measuring arthrotomy leakage over 3 minutes. Mean total leakage was 356 mL and 89 mL in the control and experimental groups, respectively (p = 0.027). Using 8 of the 10 knees (4 closed with control sutures, 4 closed with an experimental suture), a tense hemarthrosis was again created, and iatrogenic suture rupture was performed: a proximal suture was cut at 1 minute; a distal suture was cut at 2 minutes. The impact of suture rupture was compared by measuring total arthrotomy leakage over 3 minutes. Mean total leakage was 601 mL and 174 mL in the control and experimental groups, respectively (p = 0.3). In summary, using a cadaveric model, arthrotomies closed with a single bidirectional barbed running suture were statistically significantly more water-tight than those closed using a standard interrupted technique. The sample size was insufficient to determine whether the two closure techniques differed in leakage volume after suture rupture.