Initial stability of two different adhesives compared to suture repair for acute Achilles tendon rupture—A biomechanical evaluation

Abstract

Purpose Treatment of acute subcutaneous Achilles tendon rupture remains challenging. Whereas the results of conservative and operative treatment are inconsistent, early mobilisation treatment seems to be beneficial. Besides suture repair, operative treatment using adhesives reveals promising results. Our hypothesis was that a gluing technique provides initial stability comparable to sutures.

Medial Achilles tendon island flap—a novel technique to treat reruptures and neglected ruptures of the Achilles tendon

“…Variations in study design and postoperative regimes makes comparison between different surgical techniques difficult and therefore no method has been shown to be superior or inferior to another. Primary repair with end-to-end suture, which in acute ruptures provide a good biomechanical strength to the rupture site [9], has however not been considered to be appropriate for neglected ruptures [10] due to fibrotic contraction and atrophy of the proximal tendinous complex, often resulting in a large gap in the tendon. Skin retraction over the rupture site and extensive surgical exposure to the calf increases the risk for complications, especially major wound healing problems [11].…”

Development of a Surgically Optimized Graft Insertion Suture Technique to Accommodate a Tissue-Engineered TendonIn Vivo

“…Results were compared with the standard MK repair technique, which is considered one of the gold standards for a tendon repair because it is less obstructive and damaging to the tendon. 45,46 …”

Different Sutures in the Surgical Treatment of Acute Closed Achilles Tendon Rupture

“…The common materials include sutures and adhesive materials. Johannes [10] reported that the sutures have a more obvious biomechanical superiority than the adhesive material. Wapner [16] suggested the use of nonabsorbable sutures in open surgery.…”

“…Conservative treatment has fewer wound complications, but higher re-rupture rate [6][7][8]. Surgical treatment provides postoperative satisfaction and faster speed of recovery, but has higher probability of complications including scars, wound infection, delayed healing, Achilles tendon adhesion, and ankle activity limitation [9,10]. In recent years, it is noted that the suture material can greatly reduce the incidence of complications, as well as supply sufficient intensity so that patients can perform early functional exercises.…”