A modified suture technique using polydioxanone (PDS II) for capsule closure in total knee arthroplasty: a prospective randomized study compared with traditional suture technique

Purpose: To describe and evaluate the modified suture technique using PDS II for capsule closure in Total knee arthroplasty.

Methods: One hundred-five patients with end-stage osteoarthritis of the knee received Total knee arthroplasty (TKA) in our department. The arthrotomy wounds were closed randomly utilizing either modified suture (the MS group, 53 patients) or traditional suture (the TS group, 52 patients) techniques. The time of suturing, rupture of the suture, water tightness, wound seepage and the days of hospitalization were recorded and compared between the two groups. Complications such as infection and rejection of the wound were also assessed.

Results: Records indicated significantly shorter time of suturing for the capsule in the MS group (4.6 ± 0.6 min) than in the TS group (16.8 ± 1.1 min, P < 0.001). The mean time of hospitalization was also significantly shorter in the MS group (7.8 + 1.8d) than in the TS group (13.1 + 2.7d, P < 0.001).There were 51 cases in MS group and 42 cases in TS group showed good tightness, the rate of tightness in the MS group (51/53) was significantly higher than in the TS group (42/52, P = 0.015).The rate of postoperative wound seepage in the MS group (3/53) was significantly lower than in the TS group (11/52, P = 0.023). The rate of rupture of the suture in the MS group (0/53) showed no significantly difference compared with the TS group (3/52, P = 0.118). There were no complications such as infection and rejection occurred in both groups.

Conclusion: The modified suture technique using PDS II appears to be a promising option for the capsule closure in TKA because it was associated with shorter surgical time, better water tightness, fewer wound see-page, shorter of hospitalization and relatively fewer complications.