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ORIGINAL RESEARCH article

Front. Surg.

Sec. Orthopedic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1655296

This article is part of the Research TopicBeyond Standardization in Knee Surgery: Time to Think PersonalizedView all 7 articles

Clinical outcomes of modified intradermal vs. traditional intermittent suture technique in total knee arthroplasty: a single-center retrospective study

Provisionally accepted
Changzhi  HuangChangzhi Huang1*Jiuzao  LinJiuzao Lin1Shimin  ZhangShimin Zhang2Nanyi  XuNanyi Xu2Xiaoyong  WangXiaoyong Wang1
  • 1Department of Joint Surgery and Sports Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China., Ningde, China
  • 2Ningde Clinical Medical College of Fujian Medical University, Ningde, Fujian, P. R. China., Ningde, China

The final, formatted version of the article will be published soon.

In recent years, intradermal suture has gained increasing popularity due to its aesthetic incision and minimize scar formation. However, its efficacy compared to conventional intermittent suture in TKA remains unclear. Therefore, we performed a retrospective study to evaluate the association between these two skin closure techniques and outcomes in patients underwent TKA. A total of 100 patients with unilateral knee osteoarthritis, who underwent TKA between2020 and2022 in our hospital, were selected based on inclusion and exclusion criteria. Patients were allocated to either a traditional suture group or a modified suture group according to skin closure method, with 50 patients in each group. The cohort consisted of 44 males and 56 females, with a mean age of 67.50±6.14 years and a mean disease duration of 8.26±4.05 years. HWES, PSAS, and OSAS were compared 1,2,6,12,24 weeks postoperative, while the ROM were assessed 6,12,24 weeks post-surgery and VAS were compared 1,3,5,7,14 days postoperative. Data collection was performed by independent assessors. Compared to the traditional group, the incision suture time, number of suture reactions, postoperative hospitalization time, PSAS, and OSASof the modified group were lower. The VAS scores of the modified group were lower than those of the traditional group at 3, 5, and 7 days postoperative; the HWES scores at 1, 2, 6, 12, and 24 weeks postoperative; and the satisfaction scores of the incision aesthetics were significantly greater than those of the traditional group. The number of incision dressing changes, incision alignment cases, incision exudation cases, and non-grade A healing cases in the modified group were slightly lower than those in the traditional group, with no statistical significance. The flexion angle, extension angle, and flexion-extension angle of the knee joints in the two groups at 6, 12, and 24 weeks postoperative were significantly greater than those at baseline, but the differences were not statistically significant. The modified intradermal suturing technique was associated with significant improvements in scar condition and patient satisfaction with the aesthetic outcome of the incision. It was associated with shorter suturing time, lower incidence of suture reactions, and shorter postoperative hospitalization time compared with the traditional intermittent method.

Keywords: total knee arthroplasty(TKA), Intradermal suture, Wound Healing, incisionsuture, cosmetic suture, Suture technique

Received: 06 Jul 2025; Accepted: 20 Oct 2025.

Copyright: © 2025 Huang, Lin, Zhang, Xu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Changzhi Huang, hcz555@126.com

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