Flexion vs. extension suturing of Total Knee Replacement wounds: a randomised prospective study

We performed a randomised prospective trial of suturing TKR wounds in either flexion or extension. 70 TKRs were sutured in extension and 63 in flexion. The knees sutured in flexion had a better range of flexion 6 days post-operatively (P < 0.03), but by 3 months post-operatively the difference was only 4 degrees and not statistically significant (P > 0.05). Those knees sutured in flexion achieved 75 degrees of flexion earlier than those sutured in extension (P < 0.05), making earlier discharge from hospital possible. Those knees sutured in flexion had less wound complications than those sutured in extension (17% vs. 6%) but this was not statistically significant (P > 0.05).