Using a prospective , randomized , within-patient controlled study design I compared wound closure performed with bidirectional barbed sutures in one knee of bilateral TKAs performed under the same anesthetic with those performed with standard sutures in the other knee to determine whether the barbed suture was associated with ( 1 ) faster closure times ; ( 2 ) fewer intraoperative suture issues , such as needle sticks or suture breakage , and fewer postoperative wound complications ; ( 3 ) no detrimental effect on clinical outcomes , including knee ROM and Knee Society scores ; and ( 4 ) lower total operative cost , considering suture material cost and operating room time savings .