title: Biomechanical comparison of three methods for distal Achilles tendon reconstruction.
abstract: OBJECTIVE
  To compare the load at failure and stiffness associated with three surgical techniques for distal Achilles tendon reconstruction (AT).
  
  
  METHODS
  Nine matched pairs of fresh-frozen human cadaveric ATs were divided into three groups. Distal AT reconstruction was performed using suture anchors or one of two lengths of tendon overlap (10 or 5 mm). Each tendon was loaded to failure. The load at failure (N), stiffness (N/mm), and mode of failure were recorded. Differences in load at failure and stiffness were analysed.
  
  
  RESULTS
  Mean load at failure was significantly higher in the 10-mm group than in the 5-mm group (p < 0.05) or the suture-anchor group (p < 0.05). Load at failure did not differ significantly between the suture-anchor and 5-mm group, and stiffness did not differ significantly between any two groups. In the 10- and 5-mm groups, failure was caused by the grafts pulling out through the substance of the AT. Modes of failure varied in the suture-anchor group.
  
  
  CONCLUSIONS
  The load at failure was higher in the 10-mm group than in the 5-mm and suture-anchor groups. Although all three surgical techniques provide sufficient primary load-bearing ability, the 10-mm tendon-overlap technique may be more conducive to early post-operative rehabilitation.
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Wulumuqi Middle Road No.12, Shanghai, China.
authors.forename: Ziying
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Wulumuqi Middle Road No.12, Shanghai, China. hua023@hotmail.com.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Hua
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Wulumuqi Middle Road No.12, Shanghai, China.
authors.forename: Hongyun
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Wulumuqi Middle Road No.12, Shanghai, China.
authors.forename: Shiyi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Wulumuqi Middle Road No.12, Shanghai, China.
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Li
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000503:physiopathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012421:Rupture; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000503:physiopathology* / Q000601:surgery*; D058971:Tenotomy; D014182:Transplantation, Autologous; D019737:Transplants / Q000601:surgery
keywords: Achilles tendon reconstruction; Chronic Achilles tendon rupture; Suture anchor