Bidirectional barbed
sutures (BBSs) have recently been investigated in
total knee arthroplasty (TKA). The contrasting results from the scarce literature suggest that BBSs are safe, save time and money, and give results comparable to traditional
sutures. The purpose of the study is to test the real effect of BBSs on closure time in TKA and assess the functional results as well as the complications related to them. It was a randomized controlled trial. Eighty-five patients undergoing primary TKA were assigned to receive traditional closure with
Vicryl (V-group) or with BBSs (Q-group). The exclusion criteria were significant coronal
deformity, flexion
contracture, or the need for stem and/or augmentation. The closure time for the
capsule and that for the subcutaneous layer were registered separately. Intraoperative incidences were recorded. The follow-up was up to 1 month, during which the range of motion (ROM), superficial or deep
infection, and
wound dehiscence were assessed. There was a significant reduction in the
capsule layer (27 seconds; p = 0.02) and global time closure (51 seconds; p = 0.01) in the Q-group. No differences were found in the subcutaneous layer (24 seconds; p = 0.055). There were more intraoperative
suture breakages in the Q-group, mainly in the subcutaneous layer (p < 0.001). No differences in terms of dehiscence,
infection, and ROM were observed at the 1-month follow-up. BBSs allow for slightly faster
wound closure than
Vicryl during a TKA. However, the differences observed have minimal clinical repercussions. Moreover, no differences in the
infection rate (deep or superficial), dehiscence, or ROM were found.