Wound closure after total knee replacement: Comparison between staples and sutures

Area of Science:

• Orthopedic Surgery
• Wound Healing
• Biomaterials

Background:

• Total Knee Arthroplasty (TKA) is a prevalent surgical procedure for managing knee arthritis.
• Effective wound closure is critical for optimizing functional outcomes and minimizing patient morbidity post-TKA.
• Improving TKA outcomes necessitates advancements in surgical techniques, including wound closure methods.

Purpose of the Study:

• To compare the efficacy of two distinct wound closure techniques following TKA: polypropylene sutures versus surgical staples.
• To gather subjective and objective data to determine the superior closure method for enhanced TKA results.
• To contribute evidence-based insights for refining surgical practices in total knee replacement.

Main Methods:

• A randomized trial was conducted involving patients aged 40-70 undergoing bilateral TKA.
• Wound closure was performed using polypropylene sutures on one knee and staples on the contralateral knee.
• Wound healing was objectively assessed using the Hollander score by two independent evaluators.

Main Results:

• Thirty patients with bilateral TKA were analyzed, with a majority being female (71.8%).
• Knees closed with sutures demonstrated significantly higher Hollander scores compared to those closed with staples (p<0.001 for both knees).
• Female patients exhibited significantly higher Hollander scores than males in both right (p=0.049) and left knees (p=0.044).

Conclusions:

• Suture closure of surgical wounds in total knee arthroplasty yields superior outcomes compared to staple closure.
• The Hollander score, a measure of wound healing, was significantly better when sutures were employed.
• This finding supports the use of sutures over staples for improved wound management in TKA patients.