Clinical Outcomes of Closuring Technique in Total Hip Arthroplasty and Total Knee Arthroplasty: A Comparative Study of Staples technique vs Triclosan-coated Barbed Sutures.

Abstract

Background: The demand for total joint arthroplasty (TJA) continues to rise due to an aging population, increased life expectancy, and expanding surgical indications. Medicare projections estimate a 176% increase in total hip arthroplasty (THA) and a 139% increase in total knee arthroplasty (TKA) by 2040, reaching 659% and 469%, respectively, by 2060.

Methods: From January 2014 to October 2024, our arthroplasty database was categorized into two groups by closure method: Group 1 (with staples), Group 2 (with barbed sutures). Data included demographics, BMI, comorbidities, wound complications, hospital stay, and readmissions.

Results: This retrospective study of 3,110 hip and knee arthroplasty patients with osteoarthritis found no significant differences in age (P = 0.26) or sex distribution (P = 0.778) between groups, though the second group had a higher BMI (28.43 ± 4.43 vs. 29.15 ± 3.44; P < 0.001) and a more balanced operated limb distribution (P = 0.040). Comorbidities were lower in the second group for arterial hypertension (48.48% vs. 57.63%; P < 0.001), diabetes mellitus (20.8% vs. 26.21%; P = 0.0004), and hyperlipidemia (26.8% vs. 33.28%; P < 0.001), with no significant differences in ischemic heart disease (P = 0.668), atrial fibrillation (P = 0.725), or hypothyroidism (P = 0.827). Operative time was longer in the second group (82.7 ± 7.44 vs. 78.4 ± 13.62 minutes; P < 0.001), while hospital stay was marginally shorter (23.33 ± 4.53 vs. 23.3 ± 5.16 hours; P = 0.039). Postoperative complication rates, including bleeding, wound dehiscence, falls, stitch abscess, and readmission, showed no significant differences. There was no observed incidence of deep infections (PJI) in the study cohort at all.

Conclusions: The study demonstrated that there were no statistically significant differences in the frequency of wound complications between the two wound closure methods in THA and TKA surgeries, indicating comparable surgical outcomes in terms of wound healing and complication rates.