Trial reportJournal of orthopaedic surgery and research2026
Continuous barbed suturing improves early recovery after primary total knee arthroplasty: a randomised controlled trial.
Trial report in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
purposeTo evaluate whether continuous barbed suturing improves postoperative pain, closure efficiency, and early functional outcomes compared to conventional interrupted suturing in primary total knee arthroplasty (TKA).
methodsIn this double-blinded randomised controlled trial, 143 patients undergoing primary TKA were assigned to continuous barbed (n = 72) or interrupted absorbable (n = 71) sutures for arthrotomy and subcutaneous closure. The primary endpoints were closure time and postoperative pain at 24 h; superiority testing was pre-specified only for VAS at 24 h (one-sided t-test, α = 0.025), whereas closure time was analysed two-sided (α = 0.05). Secondary outcomes included wound healing time, 6-month functional gain (Hospital for Special Surgery score), quality of life (EQ-5D), satisfaction, and complications.
resultsContinuous suturing significantly reduced closure times for both arthrotomy (4.2 ± 1.6 vs 6.5 ± 7.7 min; p < 0.001) and subcutaneous layers (4.8 ± 1.9 vs 5.6 ± 1.4 min; p < 0.001). Pain at 24 h was significantly lower in the continuous group (VAS 2.9 ± 2.1 vs 4.0 ± 2.1; p = 0.017). The continuous group also showed faster wound healing (22.3 vs 24.8 days; p = 0.012) and greater 6-month HSS improvement (24.5 vs 16.0 points; p = 0.040). No significant differences were observed in complication rates, satisfaction, or quality of life.
conclusionContinuous barbed suturing improves surgical efficiency, reduces early postoperative pain, accelerates wound healing, and enhances functional recovery without increasing complication rates. This is the first randomised trial to demonstrate superior functional recovery (HSS score) with barbed continuous closure over traditional interrupted techniques, supporting its broader adoption in primary TKA. LEVEL OF EVIDENCE: Level I, randomised controlled trial.
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