Analysis of Standard Versus Barbed Sutures in Primary Total Knee Arthroplasty.
Clinical Outcomes and Cost Analysis of Standard Versus Barbed Sutures for Closure in Primary Total Knee Arthroplasty: A Single Blinded Multicenter Prospective Randomized Trial.
The purpose of this prospective study is determine if barbed sutures are more efficient, have comparable complication rates, clinical outcomes, and cosmesis outcomes versus traditional knotted sutures when used in the closure of primary total knee arthroplasty (TKA).
Barbed suture has been associated with improved closure efficiency and safety in TKA in prior studies. The investigators performed a multicenter randomized controlled trial to determine the efficiency and safety of this technology in TKA. The investigators prospectively randomized 411 patients undergoing primary TKA to either barbed running (n=191) or knotted interrupted suture closure (n=203). Closure time was measured intraoperatively. Cost analysis was based on suture and operating room time costs.
研究概览
地位
条件
详细说明
Total knee arthroplasty (TKA) rates have consistently risen in recent years, and demand is expected to increase by over 600% in the next 20 years. Decreasing reimbursement and available resources make tangible advances in surgical efficiency and outcomes essential in meeting current and future demand. Closure time may be one of the best targets in the push to reduce operative time and cost while increasing operative productivity. Optimizing lengthy, multilayered wound closures in TKA is a promising means for improving both efficiency and outcomes by potentially decreasing wound closure time, reducing postoperative wound complications, and improving cosmetic outcomes.
Running knotless suture technique utilizing barbed suture technology has recently been shown to reduce wound closure time in both total hip and knee arthroplasty in a small, prospective, randomized clinical trial. Barbed suture technology has also facilitated rapid closure and soft-tissue repair in plastic-surgery literature. Very few studies have reported on the use of barbed suture technology for multilayered closure in orthopedics. As a pilot study, the investigators performed a retrospective analysis of consecutive cohorts before and after changing to barbed suture. The investigators believed that our published slight improvement in efficiency and cost savings of a barbed suture closure was underestimated due to the retrospective nature of our pilot study and the investigators therefore elected to proceed forward with a prospective randomized trial. Additionally, in the investigators pilot study we found a potential trend toward lower wound complications with the barbed suture and we wanted to see if this would be borne out in a prospective randomized trial.
The investigators hypothesized that a prospective study would show that barbed sutures would be more efficient, have comparable complication rates, clinical outcomes, and cosmesis outcomes versus traditional knotted sutures when used in the closure of primary TKA. Specifically, the investigators hypotheses were as follows: multilayered closure in TKA with barbed suture would be associated with (1) shorter closure times; (2) lower cost; (3) similar closure related perioperative complication rates; and (4) similar Knee Society, cosmesis, and patient satisfaction scores when compared to standard knotted suture closure.
研究类型
注册 (实际的)
联系人和位置
学习地点
-
-
North Carolina
-
Durham、North Carolina、美国、27710
- Duke University Health System
-
-
Ohio
-
New Albany、Ohio、美国、43054
- Joint Implant Surgeons Inc,
-
-
Texas
-
Temple、Texas、美国、76508
- Scott and White Healthcare
-
-
Utah
-
Salt Lake City、Utah、美国、84106
- University Of Utah Orthopedics Center
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Patients greater than 18 years of age
- Undergoing primary total knee arthroplasty
- English speaking
Exclusion Criteria:
- Patients less than 18 years of age
- Prior open knee surgery in close proximity (<2cm) to the proposed incision for the primary total knee arthroplasty (prior arthroscopic surgery does not exclude a patient from the study)
- Wound or Scar in close proximity (<2cm) to the proposed incision for the primary total knee arthroplasty
学习计划
研究是如何设计的?
设计细节
- 观测模型:队列
- 时间观点:横截面
队列和干预
团体/队列 |
---|
Barbed sutures
Barbed sutures are self-anchoring, requiring no knots for wound closure.
|
Knotted sutures
Knotted sutures used for traditional surgical closures.
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
Intraoperative closure time in total knee arthroplasty.
大体时间:6 weeks
|
6 weeks
|
次要结果测量
结果测量 |
大体时间 |
---|---|
Cost analysis in terms of operative time and material costs of closure in total knee arthroplasty.
大体时间:6 weeks
|
6 weeks
|
合作者和调查者
调查人员
- 首席研究员:Christopher Peters, MD、University of Utah hopsital
- 首席研究员:Jeremy Gililland, MD、University of Utah Orthopaedics Resident
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
膝关节病的临床试验
-
Swansea University完全的
-
Scripps Translational Science Institute完全的