OBJECTIVES:  To compare economic and clinical outcomes between patients undergoing knee replacement for osteoarthritis with use of STRATAFIX™ Knotless Tissue Control Devices (SFX KTCD) vs. conventional sutures alone. METHODS:  Retrospective, observational study using the Premier Hospital Database. Patients (aged ≥18 years) selected for study had an elective hospital admission, with discharge occurring between 1/1/2010-9/1/2015, carrying primary ICD-9-CM procedure and diagnosis codes for knee replacement and osteoarthritis (first qualifying=index admission). Patients with any billing record for use of SFX KTCD during the index admission were classified into the ‘SFX KTCD group’; those with billing records only for conventional sutures were classified into the ‘conventional group’. Primary outcomes were index admission’s length of stay (LOS), total hospital costs, and discharge status (skilled nursing facility [SNF]/other vs. home/home health care); exploratory outcomes included surgical site infection (SSI) and operating room time (ORT) during index admission. The SFX KTCD and conventional groups were propensity score matched (1:1/nearest neighbor/caliper=0.10) on patient, hospital, and provider characteristics. Generalized estimating equations accounting for hospital-level clustering after matching were used to compare outcomes between study groups. RESULTS:  Each group comprised 7,264 patients (14,528 total patients; mean age=66.5y; % females=61.8%). The groups were generally well-balanced on matching covariates: mean standardized difference calculated across 52 covariates=0.02. Compared to the conventional group, the SFX KTCD group had statistically significant: shorter LOS (2.7d vs. 2.9d, P=0.0059), lower probability of discharge to SNF/other vs. home/home healthcare (25.7% vs. 28.7%, P=0.0126), and shorter ORT (183min vs. 190min, P=0.0235). Total hospital costs and SSI rates were lower for the SFX KTCD vs. conventional group; however, these differences were not statistically significant. CONCLUSIONS:  Among patients undergoing knee replacement for osteoarthritis in real world clinical practice, use of SFX KTCD vs. conventional sutures alone was associated with shorter LOS, shorter ORT, and less resource intensive discharge status.