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Initial Achilles tendon repair strength—synthesized biomechanical data from 196 cadaver repairs

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Abstract

Purpose

The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures.

Methods

We performed a systematic search of the keywords “Achilles tendon AND (suture strength OR biomechanics) AND (cadaver NOT animal)” in the online databases PubMed, EMBASE, CINAHL, and the Cochrane Library. We included studies that employed open, mini-open, or percutaneous Achilles tendon repair in human cadavers, and assessed some measure of tensile strength as a primary outcome.

Results

Our search produced 11 relevant papers reporting results for Kessler, Bunnell, and Krackow sutures in open repair, as well as the Achillon device, the Ma-Griffith repair technique, the triple bundle technique and the “giftbox” technique. The weighted tensile strengths ranged from 81 to 453 N (mean 222.7 N) with the Triple Bundle technique in combination with # 2 Ethibond performing best with a mean of 453 N.

Conclusions

Due to the small sample sizes, different study designs, and heterogeneity of strength measurement techniques, definite recommendations on surgical technique cannot be made but presented information might help in the decision making process for foot and ankle surgeons.

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Authors and Affiliations

  1. Sports Medicine Research Laboratory, Department of Orthopedic Surgery, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA

    Patrick Sadoghi & Patrick Vavken

  2. Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria

    Patrick Sadoghi & Andreas Leithner

  3. Department of Orthopaedic Surgery, University Hospital Basel, Basel, Switzerland

    Claudio Rosso & Victor Valderrabano

  4. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Claudio Rosso

  5. Harvard Center for Population and Development Studies, Harvard School of Public Health, Boston, MA, USA

    Patrick Vavken

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  1. Patrick Sadoghi
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  2. Claudio Rosso
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  3. Victor Valderrabano
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  4. Andreas Leithner
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  5. Patrick Vavken
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Correspondence to Patrick Sadoghi.

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Sadoghi, P., Rosso, C., Valderrabano, V. et al. Initial Achilles tendon repair strength—synthesized biomechanical data from 196 cadaver repairs. International Orthopaedics (SICOT) 36, 1947–1951 (2012). https://doi.org/10.1007/s00264-012-1533-6

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  • DOI: https://doi.org/10.1007/s00264-012-1533-6

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