Knotless Suture in Revision Total Joint Arthroplasty

Traditional closure will consist of arthrotomy (deep layer) closed with figure of eight number 1 vicryl plus followed by closure of the intermediate layer with 0 Vicryl plus. The intermediate layer will be performed at surgeon's discretion especially in thin patients. Subdermal layer with 2-0 vicryl suture followed by subcuticular 3-0 monofilament suture (monocryl PLUS, Ethicon; Johnson \& Johnson) and Dermabond advanced.

The barbed suture closure will consist of number 2 Stratafix symmetric PDS PLUS for the arthrotomy, intermediate layer will be performed at surgeon's discretion in thin patients, if performed will entail stratafix spiral, subdermal 2-0 stratafix spiral monocryl plus. Followed by subcuticular 3-0 stratafix spiral monocryl plus suture and Dermabond advance.

"1. The capsule will be closed with Vicryl Plus number 1~2. Deep fascia with figure of eight interrupted number 1 braided absorbable suture (Vicryl plus, Ethicon; Johnson \&Johnson, Somerville, NJ)~3. Subdermal fat layer simple interrupted knots using number 2-0 braided absorbable sutures (Vicryl plus)~4. Subcuticular 3-0 monofilament suture (monocryl plus , Ethicon; Johnson \& Johnson)~5. followed by the use of skin adhesive (Dermabond Advanced, Ethicon; Johnson \&Johnson)."

"1. The capsule will be closed with stratafix symmetric PDS Plus~2. Deep fascia will be closed with Stratafix Symmetric PDS Plus (Stratafix symmetric PDS plus, Ethicon; Johnson \&Johnson, Somerville, NJ)~3. Subdermal layer with running number 2-0 barbed suture (stratafix spiral monocryl plus, Ethicon; Johnson \& Johnson, Somerville, NJ)~4. Subcuticular suture with stratafix spiral monocryl plus, Ethicon~5. followed by the use of skin adhesive (Dermabond advanced, Ethicon; Johnson \&Johnson)."