Abstract
Introduction: Open Repair of the Achilles tendon is associated with problems of wound breakdown and infection. Percutaneous methods have been associated with sural nerve injury. The Achillon system avoids these problems. However no studies have assessed the strength of this repair and whether it allows early active rehabilitation.
Materials/Methods: Simulated Achilles tendon ruptures in sheep Achilles tendons were repaired using either the Achillon method or a two strand Kessler technique with a No.2 Ticron Suture. The tendon diameter was measured in all cases, and was matched for both groups (mean 9mm, range 8–10mm). Specimens were loaded to failure using an Instron tensile testing machine.
Results: Mean load to failure for the Achillon method was 153.13N ± 59.64 (range 65–270), and the mean load to failure for the Kessler Repair was 123.13N ± 24.19 (range 75–150). This difference was not statistically significant p=0.209. A Pearson’s correlation coefficient was carried out for each group to see if mean load to failure was related to tendon diameter. There were statistically significant higher mean loads to failure for wider tendon repaired by the Achillon method p=0.047, however this was not the case with Kessler repairs p=0.231.
Discussion: The Achillon repair had a similar load to failure as the 2 strand Kessler repair. These results support the use of early active rehabilitation following the Achillon repair and we could not demonstrate stretching at the repair site. As this method is minimally invasive and does not grasp the tendon it may also have less effect on disruption of tendon blood supply and allow faster healing.
Conclusion: The Achillon repair has comparable tensile strength to Kessler Repair, and is a biomechanically sound method of repair of the acutely rupture Achilles tendon in suitable patients.
Correspondence should be addressed to: D. Singh, BOFAS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
