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“Background: Growing evidence in the orthopaedic arthroplasty literature supports the use of running bidirectional barbed suture (barbed suture) for closure of knee arthrotomies. More rapid wound closure and suture line integrity are described as its major advantages. No studies of barbed suture for the closure of posterior spinal wounds exist. The purpose of this project JIB-04 in vivo is to compare wound closure times and hospital charges using traditional closure versus barbed suture closure of posterior spine wounds created during scoliosis surgery. Methods: A quality improvement

project was initiated at a single tertiary-referral children’s hospital spine program evaluating traditional layered interrupted suture closure (group 1) and running bidirectional barbed suture closure (Quill SRS)

(group 2). Data regarding wound closure time, length of incision, fusion levels, Epoxomicin suture cost, and hospital charges were prospectively collected over a 1-month period. Results: Ten incisions comprised group 1 and 15 comprised group 2. The average wound closure times were 29.5 and 17 minutes, respectively, P = 0.006. The wound lengths between the groups were statistically comparable (P = 0.15). Taking into account the wound length, the average closure time in group 1 was 1.29 cm/min compared with 1.97 cm/min in group 2 (P smaller than 0.01). When accounting for the extra cost associated with the use of barbed sutures ($62.54; P smaller than 0.0001), the impact of a more rapid closure resulted in a difference in hospital charges of $884.60 per case (P =

0.0013). Conclusions: Barbed suture closure of spinal fusion incisions results in a 40% reduction in closure time, resulting in an $884.60 decrease in hospital charges related to operating room time. This may represent significant yearly cost savings in a high-volume spine fusion center and warrants further investigation comparing patient-related outcomes.”
“There is no golden standard management for neglected, chronic patellar tendon rupture as they are fairly rare. Nevertheless, accompanying pain can be highly debilitating. By presenting a case of patellar tendon repair, the exceptional results of a patellofemoral arthrodesis are described. A patient presented Dinaciclib supplier herself with a sustained patellar tendon rupture which was neglected for several years, causing a complete extensor mechanism dysfunction. Her most debilitating complaint was pain. As ligament reconstruction in this case was not possible, patellofemoral arthrodesis was aimed for. The pain resulting from micromotions was subsided by implementing a unique technique using a lock-key principle to obtain a patellofemoral arthrodesis. The procedure proceeded without complications. The patient followed a regular post-operative plan and is now successful in maximum weight bearing her knee without pain.