The Strength of Achilles Tendon Repair: An In Vitro Study of the Biomechanical Behavior in Human Cadaver Tendons

Abstract

Eighteen fresh frozen human Achilles tendons were used to test the ultimate strength of repaired tendon "ruptures." Three methods, the Kessler, the Bunnell, and the locking loop, were used to test the initial strength of Achilles tendon repair. The Kessler and Bunnell methods are current standard clinical configurations described for Achilles tendon repair. Under uniform and standardized laboratory conditions, the specimens were loaded to failure. The locking loop suture method was substantially stronger than either of the other two standard configurations. The latter two did not differ significantly from each other. The results of this study may be clinically relevant in terms of the choice of the repair method for surgically treated Achilles tendon ruptures.

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

“…However, based on the active components these factors should not be of significant influence. Since the presented biomechanical properties after suture repair are comparable to previous studies, the use of sheep tendons in our study does not appear to bias the data significantly [19,21,31].…”

Achilles Tendon Repair Under Local Anesthesia

“…Biomechanical studies have confirmed significantly stronger repair with the proposed method in comparison to other percutaneous methods and comparable results to the open methods (Assal et al, 2002, Čretnik et al, 2000, Hockenbury & Johns, 1990, Watson et al, 1995, Zandbergen et al, 2005 (Čretnik et al, 2000,. Watson et al, 1995, Zandbergen et al, 2005.…”

Tendon and Ligament Tissue Engineering, Healing and Regenerative Medicine

“…Controversy regarding operative versus non-operative treatment exist in the treatment of tendon ruptures that focuses on re-rupture rates and wound complications related to surgery [15,[35][36][37][38]54]. Re-rupture rate of 3.5% in the operatively treated patients and 12.6% in the nonoperative patients has been reported previously [38].…”

“…In the Achilles tendon, simple end-toend repair is most commonly performed via the Bunnel, Kessler, and Krackow techniques [35]. All these suturing techniques are acceptable for the repair of the Achilles tendon; however, the Krackow method has been shown to be superior in biomechanical and cadaveric studies and has the advantage of allowing 4 threads (and 2 knots) across the rupture site if desired [36]. However, such model of direct suturing is not suggested for the ligaments.…”