Does knee position during wound closure alter patella height following total knee arthroplasty?

2019 ◽  
Vol 89 (3) ◽  
pp. 191-195
Author(s):  
Shane Clark ◽  
Lawrence Tee ◽  
Alasdair Sutherland
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Wound Closure ◽  
Patella Height ◽  
Knee Position ◽  
Total Knee

Knee Position during Surgical Wound Closure in Total Knee Arthroplasty: A Review

2017 ◽  
Vol 31 (01) ◽  
pp. 006-012 ◽  
Author(s):  
Mhamad Faour ◽  
Nipun Sodhi ◽  
Anton Khlopas ◽  
Nicolas Piuzzi ◽  
Kim Stearns ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Wound Closure ◽  
Surgical Wound ◽  
Surgical Closure ◽  
Pain Scores ◽  
Knee Position ◽  
Total Knee

AbstractStudy areas concerning maximizing knee range of motion (ROM) following total knee arthroplasty (TKA) have come under focus by surgeons. Among the perioperative factors that were identified to affect ROM after TKAs is knee position during surgical wound closure. Therefore, the aim of this study was to review the impact of knee position during TKA wound closure on: (1) postoperative ROM, (2) wound-related complications, (3) Knee Society Score (KSS), (4) postoperative pain, and (5) muscle strength and home functional recovery. A literature search was performed using PubMed, Ovid, and Google Scholar using various combinations of the following search terms: “wound closure,” “knee position,” “surgical closure,” and “knee arthroplasty.” The studies were evaluated for outcomes after TKA and stratified based on the knee position at surgical closure. After application of inclusion and exclusion criteria, seven studies were analyzed. The total number of patients included was 516 patients (259 patients in the flexion group and 257 patients in the full extension group). Based on the reviewed literature, wound closure in flexion was associated with significant improvement in ROM recovery at earlier follow-ups after TKA (four positive and three neutral studies), better early postoperative pain scores (two positive and one neutral study), and faster physical recovery (two positive studies) (better muscle strength and early achievement of physical therapy milestones) compared with wound closure in extension. No difference was found between wound closure in flexion compared with closure in extension in terms of long-term ROM recovery, long-term postoperative pain scores, wound-related complications (seven neutral studies), knee function measured by KSS (five neutral studies), or patient satisfactions after TKA. Although the current review is limited by the number of studies that are available in the literature, it demonstrates that overall, compared with extension, surgical wound closure in flexion may provide better ROM, faster recovery, comparable patient satisfaction, and no risk of higher wound complications.

The role of wound closure in total knee arthroplasty: a systematic review on knee position

2016 ◽  
Vol 24 (10) ◽  
pp. 3306-3312 ◽  
Author(s):  
Simone Cerciello ◽  
Brent Joseph Morris ◽  
Sébastien Lustig ◽  
Katia Corona ◽  
Enrico Visonà ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Wound Closure ◽  
Knee Position ◽  
Total Knee

Fibrin sealant before wound closure in total knee arthroplasty reduced blood loss: a meta-analysis

2014 ◽  
Vol 23 (7) ◽  
pp. 2019-2025 ◽  
Author(s):  
Zhi-jun Li ◽  
Xin Fu ◽  
Peng Tian ◽  
Wen-xing Liu ◽  
Yao-min Li ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Fibrin Sealant ◽  
Wound Closure ◽  
Meta Analysis ◽  
Total Knee

scholarly journals A symmetric anchor designed barbed suture versus conventional interrupted sutures in total knee arthroplasty: A multicenter, randomized controlled trial

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096568
Author(s):  
Wei Wang ◽  
Shigui Yan ◽  
Feng Liu ◽  
Wei Chai ◽  
Jianlin Zuo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Wound Closure ◽  
Controlled Trial ◽  
Barbed Suture ◽  
Surgical Incision ◽  
Randomized Controlled ◽  
Closure Time ◽  
Total Knee

Objective: This randomized controlled study was designed to compare the wound closure efficacy and safety of barbed suture in comparison to the conventional interrupted suture for total knee arthroplasty (TKA). Methods: This multicenter, single-blind, randomized controlled trial enrolled 184 patients who underwent elective TKA between June 2017 and April 2018. The subjects were randomized between two groups. Surgical incision closure time was considered as the primary end point. Results: A total of 184 patients participated in this randomized controlled trial; 91 patients had wound closure that involved barbed suture and 93 patients underwent conventional treatment—that is interrupted suturing with nonbarbed sutures. The surgical incision closure time was shorter ( p < 0.0001) in the barbed suture group compared with the control group (15.5 ± 4.88 vs. 20.9 ± 6.30 min). However, both groups were found to be equal in terms of the rate of postoperative complications. Conclusion: Usage of the symmetric anchor designed barbed suture is safe, efficacious, and demonstrates a decrease in surgical incision closure time in patients undergoing TKA compared to interrupted closure using conventional sutures. Future studies are warranted to demonstrate clinical and economic benefits of barbed sutures.

scholarly journals Impact of flexion versus extension of knee position on outcomes after total knee arthroplasty: a meta-analysis

2016 ◽  
Vol 137 (2) ◽  
pp. 257-265 ◽  
Author(s):  
Chao Jiang ◽  
Jieqiong Lou ◽  
Wenwei Qian ◽  
Canhua Ye ◽  
Shibai Zhu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Knee Position ◽  
Total Knee
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