{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:27:25Z","timestamp":1787671645871,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Am Acad Orthop Surg","JAAOS"],"published-print":{"date-parts":[[2023,3,15]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Meticulous arthrotomy closure during total knee arthroplasty (TKA) is essential to preserve quadriceps strength and maintain proper patellar tracking. We recently encountered a subset of patients referred with anterior knee pain, a palpable retinaculum defect, and quadriceps weakness. Each patient was found to have an arthrotomy dehiscence. This study highlights arthrotomy dehiscence as a failure mechanism after TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective case series of patients who underwent primary TKA followed by subsequent capsular dehiscence was reviewed. We investigated whether the dehiscence was related to trauma, the presence of a palpable arthrotomy defect, patellar tracking, quadriceps strength, and the type of closure technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All patients had an atraumatic disruption and presented with anterior knee pain and quadriceps weakness. Fourteen of 18 patients (78%) had a palpable defect along the medial retinaculum. Nine of 18 patients (50%) had patellar subluxation or tilting. Barbed sutures were used in 13 of 18 (72%) patients. A simple arthrotomy repair (44%) or a vastus medialis obliquus advancement (56%) was used successfully in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Atraumatic arthrotomy dehiscence as a cause of TKA failure historically has been a rare event. Recently, we have noticed a disturbing number of patients presenting with this failure mechanism. With this study, we call attention to this unique atraumatic failure mechanism in patients presenting with anterior knee pain after TKA. Surgeons should be aware of this risk when using barbed sutures alone and should consider routinely reinforcing the arthrotomy with interrupted sutures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, Retrospective Case Series<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5435\/jaaos-d-22-00539","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T10:24:46Z","timestamp":1675333486000},"page":"300-304","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Arthrotomy Dehiscence After Total Knee Arthroplasty With a Barbed Suture"],"prefix":"10.5435","volume":"31","author":[{"given":"Mark","family":"Hood","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor M.","family":"Rowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Valenzeula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"McBride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Odum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5410-4292","authenticated-orcid":false,"given":"Thomas K.","family":"Fehring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"R1-20250503","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.arth.2016.12.015","article-title":"Does barbed suture lower cost and improve outcome in total knee arthroplasty? 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A meta-analysis","volume":"40","author":"Borzio","year":"2016","journal-title":"Int Orthop"},{"key":"R6-20250503","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1055\/s-0037-1615812","article-title":"The role of barbed sutures in wound closure following knee and hip arthroplasty: A review","volume":"31","author":"Faour","year":"2018","journal-title":"J Knee Surg"},{"key":"R7-20250503","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s12306-020-00654-y","article-title":"Barbed sutures reduce arthrotomy closure duration compared to interrupted conventional sutures for total knee arthroplasty: A randomized controlled trial","volume":"105","author":"Sundaram","year":"2020","journal-title":"Musculoskelet Surg"},{"key":"R8-20250503","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1007\/s11999-017-5474-7","article-title":"Are barbed sutures associated with 90-day reoperation rates after primary TKA?","volume":"475","author":"Austin","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"R9-20250503","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1055\/s-0039-1688922","article-title":"Barbed sutures in total knee arthroplasty: Are they really useful? A randomized controlled trial","volume":"33","author":"Gamba","year":"2020","journal-title":"J Knee Surg"},{"key":"R10-20250503","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s00590-015-1644-z","article-title":"Barbed versus standard sutures in total knee arthroplasty: A meta-analysis","volume":"25","author":"Meena","year":"2015","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"R11-20250503","doi-asserted-by":"crossref","first-page":"19764","DOI":"10.1038\/srep19764","article-title":"Barbed versus traditional sutures for wound closure in knee arthroplasty: A systematic review and meta-analysis","volume":"6","author":"Zhang","year":"2016","journal-title":"Sci Rep"},{"key":"R12-20250503","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.arth.2013.05.031","article-title":"Barbed versus traditional sutures: Closure time, cost, and wound related outcomes in total joint arthroplasty","volume":"29","author":"Smith","year":"2014","journal-title":"J Arthroplasty"},{"key":"R13-20250503","doi-asserted-by":"crossref","first-page":"3668","DOI":"10.1016\/j.arth.2020.06.054","article-title":"Aseptic reoperations within 1 Year of primary total knee arthroplasty markedly increase the risk of later periprosthetic joint infection","volume":"35","author":"Goldman","year":"2020","journal-title":"J Arthroplasty"},{"key":"R14-20250503","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1302\/0301-620X.103B6.BJJ-2020-2425.R1","article-title":"Increased risk of periprosthetic joint infection after acute, traumatic wound dehiscence following primary total knee arthroplasty","volume":"103-B","author":"Gausden","year":"2021","journal-title":"Bone Joint J"}],"container-title":["Journal of the American Academy of Orthopaedic Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.5435\/JAAOS-D-22-00539","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:46:56Z","timestamp":1787669216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.5435\/JAAOS-D-22-00539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,6]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.5435\/jaaos-d-22-00539","relation":{},"ISSN":["1067-151X","1940-5480"],"issn-type":[{"value":"1067-151X","type":"print"},{"value":"1940-5480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,6]]},"assertion":[{"value":"2022-07-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}