Is continuous locking suture with braided suture sufficient for arthrotomy repair in the conventional TKR? A randomized controlled trial study

Siwadol Wongsak; Kulapat Chulsomlee; Chavarat Jarungvittayakon; Suphaneewan Jaovisidha; Paphon Sa-Ngasoongsong

doi:10.1016/j.jor.2021.02.011

Is continuous locking suture with braided suture sufficient for arthrotomy repair in the conventional TKR? A randomized controlled trial study

J Orthop. 2021 Feb 12:24:47-53. doi: 10.1016/j.jor.2021.02.011. eCollection 2021 Mar-Apr.

Authors

Siwadol Wongsak¹, Kulapat Chulsomlee², Chavarat Jarungvittayakon¹, Suphaneewan Jaovisidha³, Paphon Sa-Ngasoongsong¹

Affiliations

¹ Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Thung Phaya Thai, Ratchathewi District, Bangkok, 10400, Thailand.
² Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 111 Suwannabhumi Canal Road, Bang Pla, Bang Phli District, Samut Prakan, 10540, Thailand.
³ Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Thung Phaya Thai, Ratchathewi District, Bangkok, 10400, Thailand.

Abstract

Introduction: Medial-parapatellar-arthrotomy is the standard approach for total knee replacement(TKR). No studies have clarified the outcomes as quadriceps-strength-recovery (QS) and safety of Continuous-locking-suture-technique(CLS) for the arthrotomy-repair.

Methods: Patients were randomly assigned into a CLS(n = 40) and an interrupted-horizontal-mattress(IHM, n = 40). QS, visual-analog-scale(VAS), modified-timed-up-and-go(TUGT) test, Western-Ontario-and McMasters-Universities-Osteoarthritis-Index[WOMAC] and Knee-Society-Score[KSS] were followed for 6 months'.

Results: A significantly-shorter capsular-closure-time in CLS(233 ± 40 VS 388 ± 47 sec)(p < 0.0001). There were insignificant difference in QS, VAS, TUGT, WOMAC and KSS during the 6-month follow-up period(p > 0.05 all). No wound complications were found.

Conclusion: CLS with braided-suture is safe and effective as demonstrated a recovery of the QS and knee function outcome comparable to IHM.

Trial registration: This study was registered in Thai Clinical Trials Registry on December 2015 (https://www.clinicaltrials.in.th). The registration number was TCTR20151208003.

Keywords: Capsular closure; Continuous locking suture; Functions; Interrupted suture; Quadriceps strength; Total knee replacement.