Current Concepts on Suture Types in Total Joint Arthroplasty

This current concepts paper outlines the pros and cons of the suture types used for wound closure in total joint arthroplasty (TJA). The current literature on this topic includes controversial results from numerous studies, emphasizing the need for further evaluation of the different types of suture techniques, including the advantages and disadvantages associated with each method. This paper thus investigated retrospective studies, prospective randomized control trial (RCT) studies, and systematic reviews and meta-analyses on the most common suture types used in TJA. The sutures that were chosen included barbed sutures, continuous subcuticular sutures, interrupted sutures, staples, and tissue adhesives. The key variables that were examined included overall clinical outcomes, patient satisfaction, cosmetics, and procedure time and cost. The purpose of this current concepts paper was to explore the literature on these suture techniques and compare their outcomes. We aim for this paper to enhance the literature for both surgeons and patients in better understanding the risks and benefits associated with the different suture methods. We conclude that there is need for additional prospective, well-powered, multicenter RCTs that can promote a gold standard for the most successful closure material in both hip and knee arthroplasty.