Factors influencing the tensile strength of repaired Achilles tendon: a biomechanical experiment study.
BACKGROUND
Operative treatment has been advocated as the method of choice to repair Achilles tendon rupture as surgery results in reduced re-rupture rate and faster rehabilitation. Many surgical techniques have been introduced allowing for postoperative early motion of the ankle joint. However, it is currently very difficult for surgeons to determine the optimal treatment conditions for ruptured Achilles tendon with an increasing number of end-to-end suture methods, suture materials, and epitenon suture techniques.


METHODS
In the present biomechanical experiment study based on an orthogonal design, thirty-two New Zealand white rabbits received Achilles tendon tenotomy and subsequent operative treatment to repair the tendon employing four end-to-end suture methods, four suture materials, and four epitenon suture techniques. The tensile strength of the repaired Achilles tendon was investigated at four rehabilitation periods, and in comparison with the results of another sixteen rabbits with normal Achilles tendons.


RESULTS
The end-to-end suture method contributed most to the final Achilles tendon tensile strength in addition to rehabilitation period, with the highest values occurring with the use of the parachute-like ("Pa" bone) suture method. The other two factors, namely, suture material and epitenon suture technique, had relatively little influence on the results.


CONCLUSIONS
The parachute-like ("Pa" bone) surgical technique is superior to the other three end-to-end suture methods, with enhanced tensile strength of the repaired tendon. This method allows for postoperative early kinesitherapy of the ankle and knee joints. Therefore, this technique is highly recommended in clinical situations for treatment of ruptured Achilles tendon.
Jielile
Jiasharete
J
Department of Microsurgical Repair and Bone Tumor, Institute of Orthopedics, The First Teaching Hospital of Xinjiang Medical University, Urumqi 830054, China.
Bai
Jing Ping
JP
Sabirhazi
Gulnur
G
Redat
Darebai
D
Yilihamu
Tuoheti
T
Xinlin
Baoltri
B
Hu
Geyang
G
Tang
Bin
B
Liang
Bing
B
Sun
Qi
Q
D000125:Achilles Tendon / Q000293:injuries / Q000503:physiopathology* / Q000601:surgery*; D000818:Animals; D001696:Biomechanical Phenomena; D005260:Female; D066298:In Vitro Techniques; D008297:Male; D011817:Rabbits; D012421:Rupture; D013536:Suture Techniques; D013718:Tensile Strength