Comparing outcomes between barbed and conventional sutures in patients undergoing knee or hip arthroplasty
Abstract
Aim: To compare outcomes between barbed sutures and conventional sutures among patients undergoing knee or hip arthroplasty. Materials & methods: Retrospective study of patients (aged ≥18 years) undergoing elective knee/hip arthroplasty for osteoarthritis between 1 January 2013 and 1 September 2015. Patients were classified as: any Stratafix™ Knotless Tissue Control Devices (barbed suture group) used for closure vs. conventional sutures only (conventional suture group). Results: Compared with the conventional suture group, the barbed suture group had statistically significant: shorter length of stay, knee = 0.2 d; hip = 0.3 d and operating room time, knee = 7 min; hip = 22 min and lower rate of discharge to skilled nursing facility/nonhome setting (knee = 3.0%; hip = 6.8%). Conclusion: Use of barbed sutures was associated with shorter length of stay, operating room time and less resource intensive discharge status as compared with conventional sutures alone.
Supplementary Material
File (supplementary_data.docx)
- Download
- 33.48 KB
References
Papers of special note have been highlighted as: • of interest
1.
HCUP Fast Stats. Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality, Rockville, MD (2017). www.hcup-us.ahrq.gov/faststats/national/inpatientcommonprocedures.jsp.
2.
HCUPnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality, Rockville, MD (2017). https://hcupnet.ahrq.gov/#setup.
3.
Centers for Medicare & Medicaid Services. Comprehensive care for joint replacement model (2017). https://innovation.cms.gov/initiatives/CJR.
4.
Centers for Medicare & Medicaid Services. Hospital quality initiative: outcome measures (2017). www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/OutcomeMeasures.html.
5.
Centers for Medicare & Medicaid Services. Readmissions reduction program (HRRP) (2017). www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html.
6.
Chan VWK, Chan PK, Chiu KY, Yan CH, Ng FY. Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial. J. Arthroplasty 32(5), 1474–1477 (2017).
• Article of interest due to also having comparison between barbed and conventional sutures.
7.
Zhang W, Xue D, Yin H et al. Barbed versus traditional sutures for wound closure in knee arthroplasty: a systematic review and meta-analysis. Sci. Rep. 25(6), 19764 (2016).
• Article of interest due to also having comparison between barbed and conventional sutures.
8.
Borzio RW, Pivec R, Kapadia BH, Jauregui JJ, Maheshwari AV. Barbed sutures in total hip and knee arthroplasty: what is the evidence? A meta-analysis. Int. Orthop. 40(2), 225–231 (2016).
9.
Meena S, Gangary S, Sharma P, Chowdhury B. Barbed versus standard sutures in total knee arthroplasty: a meta-analysis. Eur. J. Orthop. Surg. Traumatol. 25(6), 1105–1110 (2015).
10.
Smith EL, DiSegna ST, Shukla PY, Matzkin EG. Barbed versus traditional sutures: closure time, cost, and wound related outcomes in total joint arthroplasty. J. Arthroplasty 29(2), 283–287 (2014).
• Article of interest due to also having comparison between barbed and conventional sutures.
11.
Eickmann T, Quane E. Total knee arthroplasty closure with barbed sutures. J. Knee Surg. 23(3), 163–167 (2010).
12.
Levine BR, Ting N, Della Valle CJ. Use of a barbed suture in the closure of hip and knee arthroplasty wounds. Orthopedics 34(9), e473–e475 (2011).
13.
Ethicon. STRATAFIX™ Knotless Tissue Control Devices (2017). www.ethicon.com/healthcare-professionals/products/wound-closure/tissue-control-devices.
14.
Premier Healthcare Database White Paper: Data that informs and performs. Premier Applied Sciences, Premier Inc (2018). www.premierinc.com/transforming-healthcare/healthcareperformance-improvement/premier-applied-sciences/.
15.
Quan H et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med. Care 43(11), 1130–1139 (2005).
16.
Yokoe DS, Noskin GA, Cunningham SM et al. Enhanced identification of postoperative infections among Inpatients. Emerg. Infect. Dis. 10(11), 1924–1930 (2004).
17.
D'Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat. Med. 17, 2265–2281 (1998).
18.
Hardin JW, Hilbe JM. Generalized Estimating Equations (2nd Edition). Chapman & Hall/CRC, FLUSA (2013).
19.
El Bitar YF, Illingworth KD, Scaife SL et al. Hospital length of stay following primary total knee arthroplasty: data from the nationwide inpatient sample database. J. Arthroplasty 30, 1710–1715 (2015).
20.
Nichols CI, Vose JG. Clinical outcomes and costs within 90 days of primary or revision total joint arthroplasty. J. Arthroplasty 31(7), 1400–1406 (2016).
21.
Levine BR, Ting N, Della Valle CJ. Use of a barbed suture in the closure of hip and knee arthroplasty wounds. Orthopedics 34(9), e473–e475 (2011).
22.
Sah AP. Is there an advantage to knotless barbed suture in TKA wound closure? A randomized trial in simultaneous bilateral TKAs. Clin. Orthop. Relat. Res. 473(6), 2019–2027 (2015).
23.
Yokoe DS1, Avery TR, Platt R, Huang SS. Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital. Clin Infect Dis. 57(9), 1282–1288 (2013).
24.
Austin DC, Keeney BJ, Dempsey BE, Koenig KM. Are barbed sutures associated with 90-day reoperation rates after primary TKA? Clin. Orthop. Relat. Res. 475(11), 2655–2665 (2017).
25.
Williams J, Kester BS, Bosco JA, Slover JD, Iorio R, Schwarzkopf R. The association between hospital length of stay and 90-day readmission risk within a total joint arthroplasty bundled payment initiative. J. Arthroplasty 32(3), 714–718 (2017).
Information & Authors
Information
Published In
Copyright
© 2018 Future Medicine Ltd.
History
Received: 24 May 2018
Accepted: 10 July 2018
Published online: 2 August 2018
Keywords:
Topics
Authors
Metrics & Citations
Metrics
Article Usage
Article usage data only available from February 2023. Historical article usage data, showing the number of article downloads, is available upon request.
Citations
How to Cite
Comparing outcomes between barbed and conventional sutures in patients undergoing knee or hip arthroplasty. (2018) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2018-0047
Export citation
Select the citation format you wish to export for this article or chapter.
Citing Literature
- Neeku Salehi, P Maxwell Courtney, Chad A Krueger, Eric B Smith, David N Kugelman, Current Concepts on Suture Types in Total Joint Arthroplasty, The Guthrie Clinic Journal of Medicine, 10.3138/guthrie-2024-0028, 77, 1, (50-66), (2025).
- Barbara H Johnson, Sinchana T, Stephen S Johnston, Najmuddin Gunja, Trends in adoption of knotless tissue control devices in robotic surgery, Journal of Comparative Effectiveness Research, 10.57264/cer-2024-0229, 14, 4, (2025).
- Stephen S. Johnston, Najmuddin Gunja, Aakash Jha, Jörg Tomaszewski, Walter Danker, Economic and clinical outcomes of cesarean deliveries with skin closure using 2-octyl cyanoacrylate plus polymer mesh tape versus conventional smooth sutures plus waterproof wound dressings, The Journal of Maternal-Fetal & Neonatal Medicine, 10.1080/14767058.2025.2463390, 38, 1, (2025).
- Khalid Sarhan, Reem Reda Elmahdi, Rashad G. Mohamed, Ibrahim Serag, Mohamed Abouzid, Barbed sutures versus conventional sutures for wound closure in spine surgeries: a systematic review and meta-analysis, Neurosurgical Review, 10.1007/s10143-024-02909-9, 47, 1, (2024).
- Steven R. Glener, Pious D. Patel, Stephanie N. Serva, Dwight Mitchell Self, Joshua E. Heller, Prospective analysis of STRATAFIX™ symmetric PDS plus suture for fascial closure in spinal surgery: a pilot study, Neurosurgical Review, 10.1007/s10143-024-02671-y, 47, 1, (2024).
- Jana Flener, Brian Chen, Frank Ernst, Aaron Libolt, Najmuddin Gunja, William Barrett, Advanced Multi-Layer Watertight Closure versus Conventional Closure in Total Hip and Knee Replacement Surgery, Pragmatic and Observational Research, 10.2147/POR.S450183, Volume 15, (93-102), (2024).
- Antonio Russo, Michele Centola, Alberto Nicodemo, Alessandro Massè, The Use of Barbed Sutures in Total Hip Arthroplasty: A Systematic Review on Clinical–Surgical Outcomes, Costs, and Complications, Healthcare, 10.3390/healthcare12111063, 12, 11, (1063), (2024).
- Emilio Romanini, Gustavo A. Zanoli, Tiziana Ascione, Giovanni Balato, Andrea Baldini, Emanuela Foglia, Antonio V. Pellegrini, Francesco Verde, Stefano Zaffagnini, Barbed sutures and skin adhesives improve wound closure in hip and knee arthroplasty, Knee Surgery, Sports Traumatology, Arthroscopy, 10.1002/ksa.12055, 32, 2, (303-310), (2024).
- Rajesh N. Maniar, Bharat Mody, Hemant M. Wakankar, Indrajit Sardar, Neeraj Adkar, Rajkumar Natesan, Sameer Ali Paravath, Sanjay Pai, Unmesh S. Mahajan, Expert Consensus on Best Practices for Optimal Wound Closure in Total Knee Arthroplasty: A STRIDE Initiative for Orthopedic Surgeons of India, Indian Journal of Orthopaedics, 10.1007/s43465-023-00922-6, 57, 12, (2066-2072), (2023).
- Kai Shi, Xuanwei Chen, Bin Shen, Yue Luo, Renqin Lin, Yu Huang, The use of novel knotless barbed sutures in posterior long-segment lumbar surgery: a randomized controlled trial, Journal of Orthopaedic Surgery and Research, 10.1186/s13018-022-03165-7, 17, 1, (2022).
