Optimizing Achilles tendon repair: effect of epitendinous suture augmentation on the strength of achilles tendon repairs
by
Lee SJ, Goldsmith S, Nicholas SJ, McHugh MP, Kremenic IJ, Ben-Avi SS.
—
last modified
2009-10-09 15:17
Foot Ankle Int. 2008 Apr;29(4):427-32.
BACKGROUND: Epitendinous suture augmentation has been shown to increase gap
resistance and overall strength in flexor tendon repairs of the hand. The purpose
of this study was to evaluate the effect of various suture augmentation
techniques in Achilles tendon repair. MATERIALS AND METHODS: Eighteen
fresh-frozen cadaveric Achilles tendons were transected and repaired with a
4-strand Krackow core stitch. Suture augmentation was performed with 3
figure-of-eight stitches in 6 specimens and a running cross-stitch weave in 6
specimens. The other 6 specimens were not augmented. Each tendon was loaded to
failure on an MTS. Force to failure (defined as peak force or force at 5 mm
gapping), gapping resistance, stiffness, and elongation were compared. RESULTS:
Force to failure (p < 0.001), stiffness (p < 0.01) and gapping resistance (p <
0.05) were increased by suture augmentation. Additionally failure force and
gapping resistance for the cross-stitch augmentation was higher than the
figure-of-eight augmentation (p < 0.05). CONCLUSION: Cross-stitch augmentation of
Achilles tendon repair yields a stronger and stiffer repair with greater
resistance to gapping. CLINICAL RELEVANCE: Achilles tendon repairs augmented with
a cross stitch weave will be able to withstand substantially higher forces than
non-augmented repairs.