Advances in closure technology and technique for total joint arthroplasty: Stitches in time

Wound closure is an important, often under emphasized, step in total joint arthroplasty. Meticulous, evidence based, surgical technique is critical for optimizing postoperative function and preventing wound complications. Robust, anatomic closure of the joint capsule in total hip arthroplasty via the posterior approach is essential. Closure of the arthrotomy in total knee arthroplasty in flexion may improve postoperative range of motion, and the use of barbed suture improves efficiency and may lead to cost savings. Skin closure with running subcuticular monofilament suture with topical skin adhesives improves peri-incisional blood flow and decreases postoperative wound drainage.