Achilles Tendon Rupture Repair: Biomechanical Comparison of the Triple Bundle Technique versus the Krakow Locking Loop Technique

Jaakkola, Juha; Hutton, William; Beskin, James L.; Lee, Gregory P.

doi:10.1177/107110070002100103

Cited by 83 publications

(100 citation statements)

References 10 publications

(2 reference statements)

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“…Triple bundle repair with early range of ankle motion, compared with nonoperative approach, have been reported by Beskin et al 18 to be successful, without any re-rupture after 3 years follow up, whereas a 7.7% re-rupture was noted in the conservative approach.…”

Section: Discussionmentioning

confidence: 87%

“…Early range of ankle motion and early weight bearing has frequently been recommended in several studies, 18,21,[23][24][25][26][27][28][29][30][31][32][33] and this is based on the advantage of a stronger tendon healing and faster functional recovery. To be able to apply these advantages on an old rupture of the tendon of Achilles, a strong and durable suturing technique would be required.…”

Section: Discussionmentioning

confidence: 99%

“…17 Yet in another study, Jaakkola et al were able to prove in a cadaveric study that the Triple Bundle Suturing Technique was biomechanically superior to Krakow locking loop technique. 18 Taking into account the strength of the Triple Bundle Suturing Technique as well as the benefits of early postoperative active motion and weight bearing, we then decided to determine the applicability of this combined approach to our patients with chronic tendon of Achilles rupture.…”

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confidence: 99%

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Treatment of Chronic Achilles Tendon Rupture with Triple Bundle Suturing Technique and Early Rehabilitation: Early Results

Cañete¹,

Deiparine²

2006

Techniques in Orthopaedics

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Treatment of chronic tendoachilles ruptures with triple bundle suturing technique and an early rehabilitation program was analyzed in this study. Patients included in the study were, 18 years old and above, and those with tendoachilles ruptures of more than 4 weeks. Excluded were patients with multiple injuries, previous tendoachilles injuries, inability to follow rehabilitation protocol and patients whose tendons could not be apposed. Tendons were debrided after which they were repaired with triple bundle suturing technique. Ankle motion and weight bearing using an ankle foot orthosis was started the next postoperative day. We had 16 patients with an average age of 40 years and a 2:1 male predominance. Chronicity of the rupture averaged 2.85 months (range, 1-10 months). Full weight bearing was on the average tolerated by the patient on the second day. Evaluation on the 6th week based on a modified ankle scoring system; 8 (50%) patients were excellent; 6 (37.5%) patients were good; and 2 (12.5%) patients were fair. At the 3rd month; 15 (94%) patients had excellent and 1 (6.2%) had a fair results. Thompson's testing and ultrasound imaging showed no re-ruptures. We encountered wound dehiscence and ankle stiffness in two separate cases. Despite the chronicity of the tendoachilles rupture of our patients, we noted that this new suturing technique provided our patients with a repair that was strong enough to resist the forces of early motion and ambulation.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Treatment of Chronic Achilles Tendon Rupture with Triple Bundle Suturing Technique and Early Rehabilitation: Early Results

Cañete¹,

Deiparine²

2006

Techniques in Orthopaedics

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“…Bewährte Methoden sind End-zu-End-Nähte in den Techniken nach Bunnell, Kirchmeyr-Kessler oder Krackow [3,8,20,33,35]. Nach vergleichenden Untersuchungen von Jaakkola et al [38] sind die Nahttechniken von Krackow und die 3-Fach-Naht nach Bunnell am stabilsten.…”

Section: Offene Sehnennaht Der Achillessehnenrupturunclassified

Die Achillessehnenruptur

et al. 2014

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The rupture of the Achilles tendon is the most frequent tendon rupture in humans and it is associated with increasing incidence. The main risk factor is intrinsic degeneration of the tendon. During the rupture the person feels a whiplash or dagger thrust-like pain, followed by restricted walking ability and decreased plantar flexion of the ankle. The positive Simmond/Thompson test and a palpable dent above the tendon rupture are pathognomical. Diagnostically, ultrasound of the tendon and lateral x-ray of the calcaneus (bony pull-out of the tendon insertion) are necessary. Regarding correct indication and treatment modalities, most established conservative and surgical therapies realize optimal functional results. Surgical treatment promises better primary stability and slightly earlier better functional results, but there is the potential for surgical complications. Conservative therapy is associated with higher rates of re-rupture and healing of the tendon under elongation. Therefore, therapy planning in Achilles tendon rupture should be determined based on each patient. We recommend surgical treatment in patients with higher sporting demands and in younger patients (< 50 years).

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“…When the knot is connected away from the rupture site, 2 different research studies have reported higher repair work strength. Jaakkola et al (32) discovered that the triple bundle is almost three-fold stronger in tension that the Krackow locking loop; this distinction is generally due to the increased number of strands crossing the rupture site. Another consider this difference is that the knot was tied far from the rupture site in the triple bundle method, whereas in the Krackow strategy, the knot is connected at the rupture site.…”

Section: Surgical Factors Influencing Tendon Tension Repair:-mentioning

confidence: 99%