COMPARISON OF SUTURE METHODS FOR SKIN CLOSURE IN TOTAL KNEE ARTHROPLASTY

Abstract

Objective: To compare the outcome of simple sutures versus Monocryl® suture for skin closure in osteoarthritic patients undergoing Total Knee Arthroplasty

Study Design: Randomized Controlled Trial.

Study Setting: The study conducted at the department of Orthopedic Surgery at Jinnah Postgraduate Medical Center, Karachi

Study Duration: Three Months (April to July’2025).

Methodology: A total of 88 patients (aged 45–85 years) with radiologically confirmed osteoarthritis undergoing TKA. Participants were randomized equally to receive either traditional simple sutures or continuous Monocryl® subcuticular closure. Pain was assessed using a 10 cm Visual Analogue Scale (VAS), and cosmesis was evaluated with the Stony Brook Scar Evaluation Scale at 2-week postoperative intervals. Closure time and suture length were recorded intraoperatively. Data were analyzed using SPSS v24, with t-tests and chi-square applied as appropriate, considering p≤0.05 statistically significant.

Results: Monocryl® sutures required significantly longer closure time (8.81±1.34 vs 7.83±1.95 min, p=0.007) but used markedly less suture material (30.11±9.31 vs 80.24±17.70 cm, p<0.001). Pain scores were lower in the Monocryl® group at 2-week (2.47±1.06 vs 3.43±1.01, p<0.001) follow-ups. Cosmetic outcomes significantly favored Monocryl® at 2-week (1.75±0.65 vs 2.46±0.73, p<0.001) assessments. No differences were found at immediate postoperative evaluation.

Conclusion: Monocryl® subcuticular closure offers superior pain reduction and cosmetic outcomes compared with simple sutures in TKA, despite slightly longer closure times. These findings support Monocryl® as the preferred technique where cosmesis and patient comfort are prioritized.