Sartawi Muthana M, Kohlmann James M, Abdelsamie Karam R, Rahman Hafizur
Department of Orthopaedics, Sarah Bush Lincoln Health Center, Mattoon, IL 61938, USA.
Department of Orthopaedics, King's College Hospital London, Dubai 14143, United Arab Emirates.
J Clin Med. 2023 Jun 12;12(12):3985. doi: 10.3390/jcm12123985.
The joint closure technique used for total knee arthroplasty cases can have an impact on outcomes, especially when considering accelerated rehabilitation programs that follow surgery. In this study, we describe the details of the technical steps involved in performing the water-tight arthrotomy joint closure technique that we developed and use.
A total of 536 patients (average age: 62 years, average body mass index: 34 kg/m) with primary osteoarthritis of the knee underwent total knee arthroplasty using the modified intervastus approach between 2019 and 2021. We used the water-tight arthrotomy joint closure technique to close the knee arthrotomy incision. Any infections and complications, as well as the duration of surgery and cost related to this wound closure technique, are also reported.
Few complications were noted with this closure technique. When we first started using it, there was one case of drainage through the proximal capsular repair which required a return to the operating room 5 days postoperatively for an irrigation and debridement. We also had two cases of superficial skin necrosis along a small part of the incision line which were observed on a weekly basis and which healed uneventfully with application of betadine once daily on the necrotic area. The average time for performing wound closure after total knee arthroplasty was 45 min.
We conclude that the water-tight closure approach can achieve very durable, water-tight capsule repairs and results in a decrease in postoperative wound drainage.
全膝关节置换病例中使用的关节闭合技术可能会对手术效果产生影响，尤其是在考虑术后加速康复方案时。在本研究中，我们描述了我们开发并使用的水密性关节切开术关节闭合技术所涉及的技术步骤细节。
2019年至2021年期间，共有536例（平均年龄：62岁，平均体重指数：34kg/m）膝关节原发性骨关节炎患者采用改良股内侧肌下入路进行了全膝关节置换术。我们使用水密性关节切开术关节闭合技术来闭合膝关节切开术切口。还报告了与该伤口闭合技术相关的任何感染和并发症，以及手术时间和费用。
该闭合技术几乎没有并发症。我们刚开始使用时，有1例通过近端关节囊修复处引流，术后5天需要返回手术室进行冲洗和清创。我们还有2例沿切口线一小部分出现浅表皮肤坏死，每周观察一次，通过每天在坏死区域涂抹碘伏，均顺利愈合。全膝关节置换术后伤口闭合的平均时间为45分钟。
我们得出结论，水密性闭合方法可以实现非常持久、水密性的关节囊修复，并减少术后伤口引流。
