A comparison between barbed suture and conventional suture in total knee arthroplasty: a systematic review and meta-analysis

Erliang Li; Wenjing Niu; Tingting Lu; Xiaolin Li; Tong Zhang; Jinchi Cai; Wenji Wang

doi:10.1186/s42836-020-00028-6

A comparison between barbed suture and conventional suture in total knee arthroplasty: a systematic review and meta-analysis

Arthroplasty. 2020 Mar 27;2(1):8. doi: 10.1186/s42836-020-00028-6.

Authors

Erliang Li^{1

2}, Wenjing Niu³, Tingting Lu⁴, Xiaolin Li^{1

2}, Tong Zhang², Jinchi Cai², Wenji Wang⁵

Affiliations

¹ The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, China.
² Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
³ The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, 710000, China.
⁴ GRADE Working Group China Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
⁵ Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, 730000, China. ldyygjwwj@163.com.

Abstract

Objective: The aim of this systematic review and meta-analysis was to evaluate the efficacy of barbed versus conventional sutures in total knee arthroplasty.

Methods: Two investigators independently performed data extraction and assessed study quality using the keywords "barbed suture, wound suture, total knee arthroplasty" in two search trials, individual trials, and trials from Systematic Reviews or Meta-analyses in PubMed, Cochrane Library, Web of Science, and EMBASE databases.

Result: A total of 11 articles (involving 1546 total knee arthroplasties) were included in this study. Comparison was made between barbed and conventional sutures in terms of various measures. No significant differences were identified in superficial infection and deep infection (p > 0.51; odds ratio 0.84 [95% confidence interval, 0.50, 1.4] and p > 0.28; odds ratio 0.50 [95% confidence interval, 0.14, 1.75], respectively). There was no significant difference in time for capsular suture (p < 0.05; odds ratio - 4.05 [95% confidence interval, - 4.39, - 3.71]). There existed no significant differences in Hospital for Special Surgery Knee Score and Knee Society Score (p > 0.05; odds ratio - 1.20 [95% confidence interval, - 2.98, 0.58] and p > 0.05; odds ratio - 1.62 [95% confidence interval, - 4.06, 0.18], respectively). No significant differences were revealed in suture breakage and needle stick injury (p < 0.05; odds ratio 36.51 [95% confidence interval, 7.06, 188.72] and p < 0.05; odds ratio 0.16 [95% confidence interval, 0.04, 0.72], respectively). No significant difference was exhibited in dehiscence (p = 0.99; odds ratio 0.99 [95% confidence interval, 0.41, 2.38]).

Conclusion: In total knee arthroplasty, both barbed and conventional sutures yielded similar results in terms of superficial and deep infection, Hospital for Special Surgery Knee Score, Knee Society Score, and wound dehiscence. Barbed suture was associated with higher incidence of suture breakage, shorter suture time, and less needle stick injury.

Keywords: Barbed suture; Meta-analyses; Systematic reviews; Total knee arthroplasty; Wound suture.

Publication types

Review