Knee arthrotomy repair with a continuous barbed suture: a biomechanical study

We compared knee arthrotomy closures using interrupted biodegradable sutures and running bidirectionally barbed sutures in cadaveric specimens subjected to cyclic loading. During the initial 2000 flexion cycles, both groups maintained closure and no suture ruptured. Suture throws were then sequentially cut to weaken the repairs, and the knees were cyclically flexed after each cut. Both types of suture repairs survived the cutting of the first throw or stitch and subsequent cyclical testing. However, there was a significant difference in the repairs after multiple cuts (log-rank test, P < .003). None of the knees in the interrupted suture group survived more than 3 cuts, whereas in the barbed repair group, it took the severing of as many as 7 throws for failure to occur.