Initial Achilles tendon repair strength-synthesized biomechanical data from 196 cadaver repairs.
Summary of "Initial Achilles tendon repair strength-synthesized biomechanical data from 196 cadaver repairs."
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.
Affiliation
Sports Medicine Research Laboratory, Department of Orthopedic Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA, patrick.sadoghi@medunigraz.at.
Journal Details
This article was published in the following journal.
Name: International orthopaedics
ISSN: 1432-5195
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22460821
- DOI: http://dx.doi.org/10.1007/s00264-012-1533-6
Medical and Biotech [MESH] Definitions
Tenosynovitis
Inflammation of the synovial lining of a tendon sheath. Causes include trauma, tendon stress, bacterial disease (gonorrhea, tuberculosis), rheumatic disease, and gout. Common sites are the hand, wrist, shoulder capsule, hip capsule, hamstring muscles, and Achilles tendon. The tendon sheaths become inflamed and painful, and accumulate fluid. Joint mobility is usually reduced.
Tendon Transfer
Surgical procedure by which a tendon is incised at its insertion and placed at an anatomical site distant from the original insertion. The tendon remains attached at the point of origin and takes over the function of a muscle inactivated by trauma or disease.
Muscular Dystrophy, Emery-dreifuss
A heterogenous group of inherited muscular dystrophy without the involvement of nervous system. The disease is characterized by MUSCULAR ATROPHY; MUSCLE WEAKNESS; CONTRACTURE of the elbows; ACHILLES TENDON; and posterior cervical muscles; with or without cardiac features. There are several INHERITANCE PATTERNS including X-linked (X CHROMOSOME), autosomal dominant, and autosomal recessive gene mutations.
Patellar Ligament
A band of fibrous tissue that attaches the apex of the PATELLA to the lower part of the tubercle of the TIBIA. The ligament is actually the caudal continuation of the common tendon of the QUADRICEPS FEMORIS. The patella is embedded in that tendon. As such, the patellar ligament can be thought of as connecting the quadriceps femoris tendon to the tibia, and therefore it is sometimes called the patellar tendon.
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