Effects Of Different Deep Incision Closure Methods On The Postoperative Recovery Of Knee Arthroplasty

Objective: To investigate the effect of different suture methods on the postoperative recovery of primary knee replacement according to different clinical methods of closing the deep incision.Methods: This study adopts the method of prospective randomized controlled study.Choosing the case between January 2016 and December 2016 in Department of orthopedic surgery,Affiliated Hospital of Hubei University for Nationalities which was the first unilateral total knee arthroplasty(TKA).Selecting 69 patients with primary knee arthroplasties with absorbable sutures continuous suture,interrupted suture and bidirectional agnail line continuous suture.selected 69 cases involved in statistical analysis,the average is divided into three groups,each group of 23 cases.Comparing and analyzing the date of the three groups,such as suture time,24 hour postoperative flow rate,the number of blood transfusions,The knee circumference was 24 hours after surgery.Comparing and analyzing the knee joint activity and Visual Analog Scale(VAS)score of the three group on first,third,fifth days after surgery.At last,comparing and analyzing hospital for special surger knee score(HSS)and some kind of complications such as ecchymosis,oozing on 1 week and 2 weeks after surgery.Results: 69 cases entered the final statistics,including 8 males and 61 females.The suture time was(17.70±2.53)min in the absorbable suture continuous suture group,(9.04±0.93)min in the bidirectional agnail line continuous suture group and(10.87±1.18)min in the absorbable suture continuous suture group.The differences among the groups were statistically significant(P<0.05).The 24 hour postoperative flow rate of absorbable suture interrupted suture group was(140.87±32.07)ml,(80.87±8.35)ml in the bidirectional agnail line continuous suture group and(150.00±22.61)ml in the absorbable sutures continuous suture group,respectively.The difference among the three groups were statistically significant(P<0.05).The proportion of blood transfusion patients in the three groups was 26.1%(6/17),8.7%(2/21),21.7%(5/18),and the barbed wire group was lower than that of the absorbentsuture group or the continuous suture group.The changes of circumference in each group were compared,there was no statistically significant difference among the three groups(P>0.05).There was no significant difference in knee motion between the three groups on the first,third and fifth day after operation.There was no significant difference in the knee motion on the 5th day after operation between the three groups(P>0.05).There was no significant difference in HSS score among the three groups before operation,at 1 week and 2 weeks after operation(P>0.05).In the VAS score of the first,third,fifth days after operation,there was no statistically significant difference among the three groups(P>0.05).Compared with the postoperative ecchymosis and complications,the bidirectional agnail line continuous suture groups had fewer complications and the formation of ecchymosis,and the difference was statistically significant(P<0.05).Conclusion: compared with three different suture modes and sutures in deep tissue sutue of TKA,the bidirectional barded suture can significantly decrease the suture time and increase the suture intensity,reduce the operative time,reduce the Perioperative complications,and the 24 hour postoperative flow rate without increasing postoperative pain and swelling.And the bidirectional barded suture do not affect knee motion and function.