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

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.

Surgical suture material—fundamentals

“…Wird die Oberfläche der Nahtmaterialien mit Widerhaken

Widerhaken

versehen, die so angeordnet sind, dass sie beim Einstechen an der Oberfläche anliegen, bei entgegengesetzter Bewegung heraustreten, kann auf Knotung verzichtet werden [ 13 , 14 , 15 ]. Andere Autoren weisen auf die Zeitökonomie beim Einsatz dieser Materialien hin [ 16 , 17 , 18 ] und auf ein geringeres Gesamtkomplikationsrisiko bei (arthroskopischen) Knieoperationen [ 18 ].…”

Assessing the application of barbed sutures in comparison to conventional sutures for surgical applications: a global systematic review and meta-analysis of preclinical animal studies

“…On the one hand, emerging adverse events associated with barbed sutures were identified in long follow-up visits. For example, a systematic review and meta-analysis reported higher incidence of suture breakage, which might require additional surgical interventions, thereby leading to an escalation in medical waste generation and economic loss 6 . On the other hand, effectiveness and safety seem to be controversial.…”