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Updated: Feb 16, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
[Bidirectional knotless barbed sutures during primary total knee arthroplasty: effective solution or new problem?]
D V Chugaev1, N N Kornilov1, S A Lasunskii1
1FGBU Rossijskij nauchno-issledovatel'skij institut travmatologii i ortopedii im. R.R. Vredena, Sankt-Peterburg, Rossija.
The Hypothesis Of The Study:
The use of bidirectional knotless barbed sutures for closure of capsule and subcutaneous fat tissue in primary total knee arthroplasty (TKA) is safe and time-saving.
Material And Methods:
302 patients with end-stage osteoarthritis scheduled for primary non-complex TKA were randomly divided into two prospective groups: in group I (N=102) the capsule of the knee joint and subcutaneous fat tissues were closed by continuous braided suture while in group II (N=200) by bidirectional knotless barbed sutures. The skin in both groups was closed by non-absorbable monofilament polycaproamide uninterrupted suture.
Results:
The time of the surgery was significantly shorter in group II (65,25±11,9 min) than in group I (72,5±14,7 min) (p<0.05). The volume of hidden blood loss was similar in both groups. The number of patients with superficial infection during the first two week after surgery did not differ significantly (1,9% (I) and 1% (II)): they all healed successfully after skin debridement and additional closure. There were no cases of deep periprosthetic infection (PPI). At 3-month follow-up no difference found regarding pain level and knee function (Knee Society Score).
Conclusion:
The use of bidirectional knotless barbed sutures in TKA reduces the time of surgery, does not affect the volume of hidden blood loss or PPI occurrence.
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