title: Barbed versus traditional sutures for wound closure in knee arthroplasty: a systematic review and meta-analysis.
abstract: Sutures are an increasing focus of research in knee arthroplasty (KA). Whether knotless barbed sutures (KBS) are safe and efficient in KA remains controversial. The objective of our study is to compare the clinical outcomes of KA according to wound closure method: KBS versus knotted traditional sutures (KTS). To clarify this, we conducted a systematic review and meta-analysis. Nine articles involving 10 studies were included in this study. The dataset consisted of 1729 patients with 1754 KA. Among these, 814 patients' wounds were closed with KBS and 915 with KTS. Our analysis indicates that KBS is preferable for KA wound closure given its shorter wound closure time and lower total cost; postoperative Knee Society scores and complication rates were similar to those of surgeries using KTS. The subgroup analysis revealed that closure of arthrotomy with KBS appears to be associated with a lower risk of complications. This meta-analysis indicates that use of KBS in KA reduces operative time and cost. KBS is the preferred option for wound closures, including arthrotomy and reattachment of subcutaneous and subcuticular tissues. Given the possible biases, adequately powered and better-designed studies with longer follow-up are required to reach a firmer conclusion.
authors.affiliation: Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, People's Republic of China.
authors.forename: Deting
authors.initials: D
authors.lastname: Xue
authors.affiliation: Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Houfa
authors.initials: H
authors.lastname: Yin
authors.affiliation: Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Thoracic surgery, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Honghai
authors.initials: H
authors.lastname: Ma
authors.affiliation: Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, People's Republic of China.
authors.forename: Erman
authors.initials: E
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, People's Republic of China.
authors.forename: Dongcai
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, People's Republic of China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Pan
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D017594:Publication Bias; D013536:Suture Techniques; D013537:Sutures