title: Mechanical evaluation of different techniques for Achilles tendon repair.
abstract: BACKGROUND
  One aim of the surgical treatment of acute Achilles tendon ruptures is to obtain a maximum primary stability of the sutured tendon. Therefore, we investigated the primary stability of sutured human Achilles tendons depending on different applied techniques.
  
  
  METHODS
  The strength of 60 repaired cadaveric human Achilles tendons was tested depending on either the suture technique (Bunnell or Kessler), the suture material (PDS-thread or PDS-cord) or an additional plantaris tendon augmentation (PDS-thread with or without augmentation). Following anatomic reconstruction the repaired specimens were loaded to failure.
  
  
  RESULTS
  The use of Bunnell's technique resulted in a stronger primary suture stability compared to Kessler's technique. Sutures carried out with a PDS-thread were of lower strength than those accomplished with a PDS-cord (Bunnell: thread 139 N +/- 29.8; cord 291 N +/- 55.2/Kessler: thread 137 N +/- 37.3; cord 180 N +/- 41.1). Sutures performed according to Bunnell's technique with a PDS-thread and an additional autologous plantaris tendon augmentation reached the highest primary stability (326 N +/- 124.9).
  
  
  CONCLUSIONS
  The findings identify the Achilles tendon suture with a PDS-cord according to Bunnell's technique as a mechanically strong method. A plantaris tendon augmentation in addition to a PDS-thread can even add more stability to the Achilles tendon suture.
authors: Department of Trauma, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246, Hamburg, Germany. mgebauer@uke.uni-hamburg.de
authors: Matthias
authors: M
authors: Gebauer
authors: Frank Timo
authors: FT
authors: Beil
authors: Johannes
authors: J
authors: Beckmann
authors: András M
authors: AM
authors: Sárváry
authors: Peter
authors: P
authors: Ueblacker
authors: Andreas H
authors: AH
authors: Ruecker
authors: Joerg
authors: J
authors: Holste
authors: Norbert M
authors: NM
authors: Meenen
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012421:Rupture; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*