Wound closure after total knee arthroplasty: Comparison of polypropylene and polyglactin 910 suture-a randomized controlled trial

Abstract

Objective: To compare the outcomes of wound closure using polypropylene and subcuticular polyglactin 910 sutures in patients undergoing total knee arthroplasty (TKA).

Methodology: A randomized, assessor-blinded controlled trial was conducted at the Department of Orthopedics, Indus Hospital and Health Network, Karachi, from February 2022 to February 2025, during the hospital’s Arthroplasty Week. All the patients who had undergone bilateral total knee arthroplasty in this timeframe and were eligible were included. Polypropylene sutures were used to close one knee in each patient and polyglactin 910 sutures were used to close the opposing knee. Correlations between independent and dependent variables were evaluated and regression analysis was performed.

Results: A total of 40 patients were enrolled in the study with a female predominance (67.5%). Post-operative erythema was frequent in the polypropylene group in the early post-operative days while complications were more frequently observed in the polyglactin 910 group during the later postoperative period. Female sex, diabetes mellitus, and American Society of Anesthesiologists (ASA) Grade III were significant factors associated with wound dehiscence and surgical site infection.

Conclusion: There was no statistically significant difference in postoperative complications in patients undergoing total knee arthroplasty between polyglactin 910 and polypropylene sutures. Both sutures can be effectively used for wound closure, but in the resource-limited environment, polyglactin 910 could be a better choice as it is an absorbable material, and the sutures can be removed without it.