Background: Barbed suture has been widely used in some surgical fields, and it has achieved good results, but the application in total knee arthroplasty is still controversial. Objective: Literature is collected for statistical analysis so as to provide evidence for the use of barbed suture in Total knee arthroplasty. Methods: We searched PubMed, the Cochrane library and EMBASE database for randomized controlled trials (RCTs) using barbed suture and conventional suture to close incisions after primary total knee arthroplasty, and the retrieval time was from July 2019 to the establishment of the database. Literature was screened according to inclusion and exclusion criteria, quality evaluation and data extraction were conducted for the final included literature, and statistical analysis was conducted using RevMan 5.3 software. Results: A total of six RCTs (826 knees) were included in our meta-analysis. The results showed that the re-negative conversion could shorten the wound closure time (MD –4.41, 95% CI −5.11 to −3.72, P < .00001) and reduce the wound closure total cost (MD –282.61, 95% CI –445.36 to –119.85, P = .0007) and acupuncture injury (RR 0.14, 95% CI 0.03–0.78, P = .02), and did not significantly increasing the incidence of complications (RR 0.80, 95% CI 0.05–0.96, P = .38) or suture breakages (RR 4.58, 95% CI 0.16−128.29, P = .37). There were no significant differences in ROM at postoperative 6 weeks and 3 months (MD −0.74, 95% CI −4.19 to 2.71, P = .67; MD −0.30, 95% CI −2.62 to 2.02, P = .80) and no significant differences in KSS at postoperative 6 weeks (MD –0.22, 95% CI –3.10 to 2.66, P = .88). Conclusions: Our study shows that barbed suture is a fast, low-cost, safe and effective suture method in total knee arthroplasty compared with traditional suture, we also need more literature and longer follow-up to confirm this conclusion.

Background. Staples closure technology has been widely used in total knee arthroplasty (TKA) and achieved good results. In recent years, a new type of material called skin closure tape (SCT) has been applied to TKA which also showed good treatment results. However, since it is still not clear yet which one is better, this paper collects literatures for statistical analysis so as to provide evidence for the use of SCT in TKA. Methods. The comparative study on effects between SCT and staples is reviewed after the primary release of TKA in PubMed, the Cochrane library, and the EMBASE database up to March 2019. The two researchers independently screened the literature and evaluated the quality of the literature using bias risk tools. Results. A total of four studies (3330 knees) have been included in our meta-analysis. For the main point, the results show that the SCT can reduce readmission rates compared to staples (RR 0.68, 95% CI 0.49–0.95, P = 0.03), with no significant difference in complications (RR 0.85, 95% CI 0.27–2.64, P = 0.77). Secondly, the results suggest that although there is no significant difference in removal time between the two groups, the SCT can reduce pains, save time and costs, and have a better cosmetic effect. Conclusions. Our study indicates SCT as a closure method with fewer complications and faster speed compared with staples. Nevertheless, the cost and pain need to be further confirmed because of the small sample size included in this study.