SynthesisInternational orthopaedics2016
Barbed sutures in total hip and knee arthroplasty: what is the evidence? A meta-analysis.
Synthesis in International orthopaedics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture.BMC medical research methodology · 2025Pooled it
- Effect of barbed versus standard sutures on wound complications in total knee arthroplasty: A meta-analysis.International wound journal · 2023Pooled it
- Pooled it
- A Prospective, Multi-Center, Randomized Controlled Study to Evaluate the Efficacy and Safety of Two Absorbable Barbed Sutures in Thyroid Surgery.Medical devices (Auckland, N.Z.) · 2026Trial
- Knotless suture in revision total joint arthroplasty: a prospective randomized controlled trial.Archives of orthopaedic and trauma surgery · 2024Trial
- The use of novel knotless barbed sutures in posterior long-segment lumbar surgery: a randomized controlled trial.Journal of orthopaedic surgery and research · 2022Trial
- Barbed sutures reduce arthrotomy closure duration compared to interrupted conventional sutures for total knee arthroplasty: a randomized controlled trial.Musculoskeletal surgery · 2021Trial
- Evaluation of three methods of suture for skin closure in total knee arthroplasty: a randomized trial.BMC musculoskeletal disorders · 2021Trial
- A Modified Strategy Using Barbed Sutures for Wound Closure in Total Joint Arthroplasty: A Prospective, Randomized, Double-Blind, Self-Controlled Clinical Trial.Medical science monitor : international medical journal of experimental and clinical research · 2018Trial
- Evaluation of running knotless barbed suture for capsular closure in primary total knee arthroplasty for osteoarthritis-a prospective randomized study.International orthopaedics · 2017Trial
- Consensus document on the management of wound closure in orthopaedic surgery.EFORT open reviews · 2025Review
- Article
- Prospective analysis of STRATAFIX™ symmetric PDS plus suture for fascial closure in spinal surgery: a pilot study.Neurosurgical review · 2024Article
- Barbed versus conventional suture in elective posterior spine surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Expert Consensus on Best Practices for Optimal Wound Closure in Total Knee Arthroplasty: A STRIDE Initiative for Orthopedic Surgeons of India.Indian journal of orthopaedics · 2023Article
- [Surgical suture material-fundamentals].Operative Orthopadie und Traumatologie · 2023Article
- Barbed Sutures for Total Hip and Knee Arthroplasty Have Shorter Wound Closure Time and are Cost-Effective in Comparison to Traditional Sutures: A Systematic Review and Meta-analysis of 16 Randomized Controlled Trials.Indian journal of orthopaedics · 2022Article
- A comparison of barbed continuous suture versus conventional interrupted suture for fascial closure in total hip arthroplasty.Scientific reports · 2022Article
- Impact of Whole-Layer Barbed Suture Closure on the Postoperative Effect and Aesthetic Satisfaction with Incision After Knee Arthroplasty.Patient preference and adherence · 2022Article
- Wound Complications after 2-Octyl Skin Closure Systems for Total Joint Arthroplasty.Journal of bone and joint infection · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionNewer methods of wound closure such as bidirectional barbed sutures hold the potential to reduce closure time and thus overall operating room costs during total joint arthroplasty (TJA), including total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, it is unclear whether these sutures have similar clinical outcomes or whether they place the patient at risk of developing wound complications that may outweigh the time-saving benefits of these sutures.
methodsA systematic review of the literature was performed to identify all level I trials that reported the use of barbed suture during TJA. We analyzed the efficacy, safety, major and minor complications, and overall cost related to barbed sutures.
resultsFour studies met our criteria, and included 588 patients who were randomized either to barbed suture closure (n = 290 TJAs, 268 TKAs, and 22 THAs) or to a matched conventional suture cohort (n = 298 TJAs, 279 TKAs, and 19 THA). In terms of time savings with wound closure, the barbed suture was 6.3 minutes faster than the conventional cohort (p < 0.05). The odds for developing a minor complication were nearly identical (odds ratio [OR] 1.04, p = 0.95) and for major complication was not significantly different (OR 2.94, p = 0.27). The overall mean savings including both THA and TKA was USD 298 per case.
conclusionsIn randomized controlled trials, barbed sutures are consistently associated with shorter wound closure time, which also corresponds to cost savings, even when the higher cost of these sutures is taken into account. There was no significant difference in the odds of experiencing either minor or major complications between patients in whom barbed sutures versus standard sutures were used for wound closure. Current evidence supports continued use of these sutures. LEVEL OF EVIDENCE: Level I.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.