Retention Stitches: A Concept of Wound Closure of Knee Arthroplasty in Obese Patients

Background: Knee joint arthroplasty is a commonly performed procedure. However, number of obese patients undergoing total knee arthroplasty is on a rise. In such cases, post closure using routine techniques, there have been an increasing number of cases of wound dehiscence and complications like persistent discharge and delayed healing. To overcome this problem, the author has come up with an innovative technique in closure.

Materials and methods: 27 patients, who were obese, were included in the study and operated at Orthopaedic Arthroscopic Knee and Shoulder clinic. The patients were evaluated pre operatively clinically and planned for retention stitches for closure. Same technique was followed for closure in all the patients. Suture removal was done at 2 weeks and patients were followed up for a period of 6 months for any complications.

Results: In 27 patients undergoing retention stitches post total knee arthroplasty, patients were followed up for a mean period of 14 months, with minimum being 6 months and maximum being 5 years. Patients showed no complications such as wound dehiscence, discharge, localised skin necrosis or cut-through of stitches.

Conclusion: Retention stitches in knee arthroplasty is an innovative, ideal, yet easily replicable method of wound closure in obese patients, especially with BMI > 30 (Obesity grade 1 or more). Patients undergo better and uneventful wound healing, which is of paramount importance in a surgery like this. In all these patients, the rehabilitation post surgery is also similar to the other patients, hence not affecting the outcome.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-021-00596-y.