Subcuticular suture achieves better esthetics, healing, and similar functional outcomes following unicompartmental knee arthroplasty: a single center retrospective comparative study

Aims This study aimed to assess the impact of a modified intradermal suture technique on clinical outcomes and esthetic satisfaction in patients following unicompartmental knee arthroplasty (UKA). Methods A total of 80 patients with medial knee osteoarthritis, who underwent UKA between June 2023 and October 2024 at a tertiary academic hospital in Ningde, China, were selected based on inclusion and exclusion criteria. Patients were allocated to either a traditional suture group or a modified suture group, with 40 patients in each group. The cohort consisted of 32 males and 48 females, with a mean age of 67.39 ± 6.33 years (range 57–79) and a mean disease duration of 4.44 ± 1.37 years (range 1–8). Wound healing grade, Hollander Wound Evaluation Score (HWES), and Visual Analog Scale (VAS) were compared 2 weeks post-surgery, while the Patient Scar Assessment Score (PSAS), Observer Scar Assessment Score (OSAS), Range of Motion (ROM), and Hospital for Special Surgery Knee Score (HSS) were assessed 12 weeks post-surgery. Results The modified suture group showed a significant reduction in suture time, number of suture reactions, and postoperative hospital stay compared to the traditional group (6.20 vs. 3.65 min, 9 vs. 2, 6.53 vs. 5.38 days; all p < 0.05). Although there were fewer postoperative dressing changes, incidences of poor incision alignment, and complications in the modified group, these differences were not statistically significant ( p > 0.05). Two weeks post-surgery, the modified group exhibited improved HWES scores. At 12 weeks, the modified group demonstrated superior PSAS and OSAS scores (3.38 vs. 4.68, 29.83 vs. 22.40, 23.08 vs. 14.93, all p < 0.05). The VAS pain score, ROM, and HSS improved significantly in both groups compared to preoperative values (1.68 vs. 4.33, 116.43 vs. 100.53, 89.23 vs. 52.58 for the modified group, and 1.55 vs. 4.20, 116.38 vs. 101.00, 89.30 vs. 51.65 for the traditional group; all p < 0.05). However, no statistically significant differences were found between the groups post-surgery (1.68 vs. 1.55, 116.43 vs. 116.38, 89.23 vs. 89.30, all p > 0.05). Conclusion The modified intradermal suturing technique, compared to the traditional intermittent method, significantly reduces suturing time and incidence of suture reactions, enhances scar condition, and improves patient satisfaction with the esthetic outcome of the incision. It proves to be an effective suturing technique for UKA patients.