title: The Achillon achilles tendon repair: is it strong enough?
abstract: BACKGROUND
  Open repair of the Achilles tendon is associated with wound breakdown, infection and percutaneous methods risk sural nerve injury. The Achillon mini-incision technique can reduce these risks and may provide the opportunity for early active rehabilitation. The aim of this study was to compare the strength of the Achillon method with the commonly used Kessler method and to assess whether the strength of the repair was related to tendon diameter.
  
  
  METHODS
  Simulated ruptures in sheep Achilles tendons were repaired using either the Achillon method or a two-strand Kessler technique with a No. 2 Ticron suture (Tyco Healthcare, UK). Each tendon diameter was measured, and matched for both groups. Specimens were loaded to failure using an Instron tensile testing machine (Instron Limited, UK).
  
  
  RESULTS
  Mean load to failure for the Achillon repair was 153 N+/-60 (range, 65 to 270), and the mean load to failure for the Kessler Repair was 123 N+/-24 (range, 75 to 150). This difference was not statistically significant (p=0.21). There was a statistically significant higher mean load to failure for wider tendons repaired by the Achillon method (p=0.05), however mean load to failure was not related to tendon width in Kessler repairs (p=0.23).
  
  
  CONCLUSIONS
  This is the first study to compare these two methods of repair. The Achillon repair has comparable tensile strength to the Kessler Repair.
  
  
  CONCLUSIONS
  The Achillon repair appears to be a biomechanically sound method of repair for the acutely ruptured Achilles tendon.
authors.affiliation: Basingstoke and North Hampshire Hospital Foundation Trust, Orthopaedics, Hampshire, UK.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ismail
authors.forename: Amer
authors.initials: A
authors.lastname: Karim
authors.forename: Ryan
authors.initials: R
authors.lastname: Shulman
authors.forename: Andrew
authors.initials: A
authors.lastname: Amis
authors.forename: James
authors.initials: J
authors.lastname: Calder