A biomechanical comparison of Achilles tendon suture repair techniques: Locking Block Modified Krackow, Kessler, and Per
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ARTHROSCOPY AND SPORTS MEDICINE
A biomechanical comparison of Achilles tendon suture repair techniques: Locking Block Modified Krackow, Kessler, and Percutaneous Achilles Repair System with the early rehabilitation program in vitro bovine model Jian Tian1 · Yongjun Rui1 · Yajun Xu1 · Wengbo Yang2 · Tonglong Xu1 · Xueming Chen1 · Xingfei Zhang1 Received: 28 February 2020 / Accepted: 15 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background The Krackow technique has the advantage of high strength, though it is not minimally invasive. The “Locking Block Modified Krackow” (LBMK) peri-tendon fixation technique was designed for minimally invasive surgery. This study aimed to compare the biomechanics of LBMK with Kessler and Percutaneous Achilles Repair System (PARS) techniques using a simulated early rehabilitation program. Materials and methods Thirty-fresh bovine Achilles tendon specimens were randomly assigned to the LBMK, Kessler, and PARS groups (n = 10). In LBMK group, the main suture configuration was the LBMK technique, and the transverse suture was used as the secondary suture configuration. The Kessler group employed three suture configurations, two sagittal, one coronal plane. In the PARS group, two transverse and one locking sutures were placed at either end of the tendon. Each repaired specimen underwent two cyclic loading protocols (20–100 N, 20–190 N), 500 cycles, followed by measurement of the gap between the tendon ends. All specimens underwent a load-to-failure test at a 25 mm/s stretching rate. Results After the first loading cycle, the average gaps of the LBMK, Kessler and PARS groups were 0.76 ± 0.44 mm, 1.80 ± 0.82 mm, and 2.66 ± 1.04 mm, respectively. The LBMK group had a significantly reduced gap than the other groups (p
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