scholarly journals Biomechanical properties of Achilles tendon repair augmented with a bioadhesive-coated scaffold

2011 ◽  
Vol 6 (1) ◽  
pp. 015014 ◽  
Author(s):  
Michael Brodie ◽  
Laura Vollenweider ◽  
John L Murphy ◽  
Fangmin Xu ◽  
Arinne Lyman ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Achilles Tendon Repair

scholarly journals Suturing Achilles tendon and mesh simultaneously in augmented repair resists gap formation foremost: an experimental study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
William McCartney ◽  
Ciprian Ober ◽  
Maria Benito ◽  
Bryan MacDonald
Keyword(s):  
Achilles Tendon ◽  
Polypropylene Mesh ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
In Vivo Studies ◽  
Control Group ◽  
Gap Formation ◽  
Achilles Tendon Repair ◽  
Mesh Augmentation

Abstract Background The common calcanean tendon (Achilles tendon) is the strongest and largest tendon and is one of the most commonly affected by spontaneous rupture. Different suture techniques are used to repair the tendon rupture. We compare the biomechanical properties of three different modalities of suture pattern in a mechanical experiment in rabbits with the purpose of evaluating the use of polypropylene mesh augmentation for Achilles tendon repair to find out the best surgical option. Methods The study tests single cycle to failure tensile strength characteristics of three different combinations of the 3-loop pulley (3-LP) suture technique with polypropylene mesh, and statistically compares the biomechanical properties as the maximum load at failure for all 3-LP repair. Results The normal Achilles tendon—control group—failed at a mean load of 25.5 + 13.6; the experimental groups failed at a significantly lower load (p < 0.001), with the group of 3-LP suture with polypropylene mesh included in the suture being the more similar to controls, but all the groups exhibited statistically significant differences with regard to normal tendons (p < 0.001). The distance at which each group failed was also significant between control and experimental groups (p < 0.001) with the exception of the suture-only group and the group with the mesh over the suture (p = 0.15). Conclusion Results from this study suggest that incorporating the mesh within the suture provides benefit to the Achilles tendon repair by improving strength and resistance to pull through. However, further in vivo studies will be necessary to confirm these results and incorporate this technique to the routine human and veterinary surgery.

scholarly journals Effects of plasma rich in growth factors (PRGF) on biomechanical properties of Achilles tendon repair

2015 ◽  
Vol 24 (12) ◽  
pp. 3997-4004 ◽  
Author(s):  
Diego López-Nájera ◽  
Mónica Rubio-Zaragoza ◽  
Joaquín J. Sopena-Juncosa ◽  
Eduard Alentorn-Geli ◽  
Ramón Cugat-Bertomeu ◽  
...  
Keyword(s):  
Growth Factors ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Achilles Tendon Repair

scholarly journals Biomechanical Comparison of Panda Rope Bridge Technique and Other Minimally Invasive Achilles Tendon Repair Techniques In Vitro

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110084
Author(s):  
Ting Wang ◽  
Yuan Mu ◽  
Yulei Diao ◽  
Wenke Liu ◽  
Yahong Wu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Repair System ◽  
Postoperative Rehabilitation ◽  
Achilles Tendon Repair ◽  
Repair Techniques

Background: Although nonoperative management of acute Achilles tendon rupture (ATR) is a reasonable option, surgical repair has attracted attention for young and active patients. More reliable Achilles tendon repair techniques are needed to enhance recovery after ATR in this population. Purpose/Hypothesis: To biomechanically analyze the panda rope bridge technique (PRBT) and compare it with other minimally invasive repair techniques over a simulated, progressive rehabilitation program. It was hypothesized that PRBT would result in better biomechanical properties and enhanced recovery after ATR. Study Design: Controlled laboratory study. Methods: An Achilles tendon rupture was created 4 cm from the distal tendon insertion site in 40 bovine lower extremities, and specimens were then randomly allocated to 5 Achilles tendon repair techniques: (1) Achillon, (2) modified Achillon, (3) Percutaneous Achilles Repair System (PARS), (4) modified PARS, and (5) PRBT. Each group was subjected to a cyclic loading protocol that was representative of progressive postoperative rehabilitation for ATR (250 cycles at 1 Hz for each loading stage: 20-100 N, 20-200 N, 20-300 N, and 20-400 N). Results: The PRBT technique demonstrated significantly less elongation (1.62 ± 0.25 mm) than the 4 other repair techniques after the first loading stage of 20 to 100 N ( P < .05). All specimens in the 4 other groups developed a large gap (elongation ≥5 mm) at the 20- to 200-N loading stage. When overall biomechanical performance was examined, the PRBT group exhibited higher strength (20-400 N) and more mean loading cycles (984 ± 10) compared with the 4 other groups ( P < .05). Conclusion: In this bovine model, PRBT biomechanically outperformed the other minimally invasive Achilles tendon repair techniques that were tested and could therefore meet the requirements of accelerated rehabilitation. Clinical Relevance: The reduced tendency for premature rerupture and the overall improved biomechanical properties of PRBT suggest that ATR patients treated with PRBT may more readily complete early and aggressive postoperative rehabilitation protocols. In addition, they may have a lower risk of early irreversible suture failure.

scholarly journals Transverse versus longitudinal incision for minimally invasive Achilles tendon repair

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0016
Author(s):  
Daniel Bohl ◽  
Eric Barnard ◽  
Kamran Movassaghi ◽  
Kamran Hamid ◽  
Adam Schiff
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Suture Material ◽  
Tendon Repair ◽  
Wound Complications ◽  
Transverse Incision ◽  
Longitudinal Incision ◽  
Achilles Tendon Repair ◽  
Deep Suture ◽  
No Tourniquet

Category: Sports Introduction/Purpose: The rate of wound complications following traditional open Achilles tendon repair is reported at 7-8%. In an effort to reduce the rate of wound complications, orthopaedic surgeons have adopted novel minimally invasive techniques. The purpose of this study is to characterize the rate of wound and other early complications following a minimally invasive Achilles tendon repair, to identify any factors associated with increased risk. Methods: The postoperative courses of 55 patients who underwent minimally invasive Achilles tendon repair by two surgeons at separate academic medical centers were retrospectively reviewed. Repair technique was similar in all cases, making use of the same commercially available suture-guidance jig, silicone-impregnated deep suture material, and locking stitch technique. However, 31 procedures used a longitudinal incision and a tourniquet (one surgeon’s preference), while 24 procedures used a transverse incision and no tourniquet (the second surgeon’s preference). Of the 24 procedures using transverse incisions, 2 had to be converted to L-shaped incisions to achieve better access to the tendon. The rates of early complications within 3 months after surgery were characterized and compared between patients with differing procedural characteristics. Results: Of the 55 patients included in the study, 2 (3.6%) developed wound complications. Both wound complications appeared to be reactions to the deep suture material (see Table 1 for details). There was no statistical difference in the rate of wound complications between patients in the longitudinal incision/tourniquet group and patients in the transverse incision/no tourniquet group (6.5% versus 0.0%; p=0.499). Three patients (5.5%) developed sural neuropraxia, which manifested as mild-to-moderate subjective numbness with sensation remaining intact to light touch. There were no cases of re-rupture. At 3-month follow-up, all 55 patients had intact Thompson tests and well-healed wounds. Conclusion: The rate of wound complications following minimally invasive Achilles repair is low at 3.6%. The present study could not demonstrate a difference in risk for wound complications between patients treated with a longitudinal incision and tourniquet and patients treated with a transverse incision and no tourniquet. The wound complications we observed were primarily attributable to inflammatory reactions to the silicone-impregnated deep suture material. Patients should be counseled that although risk for wound complications may be lower with minimally invasive techniques, such techniques do risk sural neuropraxia and deep suture reaction. Further prospective analysis is warranted.

The Effect of Obesity on Achilles Rupture Repair

2018 ◽  
Vol 12 (6) ◽  
pp. 503-512 ◽  
Author(s):  
Jeffery S. Hillam ◽  
Neil Mohile ◽  
Niall Smyth ◽  
Jonathan Kaplan ◽  
Amiethab Aiyer
Keyword(s):  
Achilles Tendon ◽  
Tendon Repair ◽  
Wound Dehiscence ◽  
Comorbid Conditions ◽  
Improvement Program ◽  
Acs Nsqip ◽  
Achilles Tendon Repair ◽  
Increased Risk ◽  
American College Of Surgeons ◽  
Tendon Ruptures

Introduction. Obesity is an increasingly common comorbidity that may negatively affect outcomes following orthopaedic surgery. It is valuable to determine whether obese patients are vulnerable for postoperative complications. The purpose of this study was to analyze data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to determine the effect of obesity on surgical treatment of Achilles tendon ruptures. Methods. Patients who underwent a surgical repair of the Achilles tendon were retrospectively identified through the ACS NSQIP. The patients were divided into 2 cohorts (obese and nonobese), then perioperative and postoperative factors were evaluated for association with obesity. Results. A total of 2128 patients were identified, of whom 887 (41.7%) were classified as obese. Obesity correlated with an increased operative time, 60.9 versus 56.1 minutes. The only postoperative complication associated with obesity was wound dehiscence. Logistic regression adjusted for comorbid conditions demonstrated that obesity was not associated with an increased risk of wound dehiscence. Conclusion. A large segment of the patient population undergoing Achilles tendon repair is obese. Obesity was found to have an increased association with wound dehiscence, likely related to comorbid conditions, following Achilles tendon repair. Obesity was not significantly associated with any other complication. Levels of Evidence: III, Retrospective Cohort Study

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