Artikel
Biomechanical comparison of three minimal invasive Achilles tendon fixation techniques
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Autoren
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Carolin Melcher
- Klinikum der Universität München (LMU), Campus Großhadern, Klinik & Poliklinik f.Orthopädie, Physik. Medizin & Rehabilitation, München, Germany
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Veronika Wegener
- Klinikum der Universität München (LMU), Campus Großhadern, Klinik & Poliklinik f.Orthopädie, Physik. Medizin & Rehabilitation, München, Germany
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Christian Renner
- Arthrex GmbH, München, Germany
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Nicole Fischer
- Arthrex GmbH, München, Germany
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Andreas Büttner
- Institut für Rechtsmedizin, Rostock, Germany
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Volkmar Jansson
- Klinikum der Universität München (LMU), Campus Großhadern, Klinik & Poliklinik f.Orthopädie, Physik. Medizin & Rehabilitation, München, Germany
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Bernd Wegener
- Klinikum der Universität München (LMU), Campus Großhadern, Klinik & Poliklinik f.Orthopädie, Physik. Medizin & Rehabilitation, München, Germany
| Veröffentlicht: | 6. November 2018 |
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Gliederung
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Background: While no gold standard has been defined for the management of Achilles tendon ruptures, surgical repair is common in healthy and active patients. Minimally invasive repair methods have become more and more common, while the question of biomechanical comparability isn't answered in conclusion
Hypothesis/Purpose: The purpose of this study was to compare biomechanical features and tendon strength of 3 minimally invasive Achilles tendon repair techniques
Methods: A midsubstance Achilles rupture was created 6 cm proximal to the calcaneal insertion in 29 fresh-frozen cadaveric ankles. Specimens were then randomly allocated to 1 of 3 different Achilles repair techniques: (1) the PARS Achilles Jig System, (2) the Achilles Midsubstance SpeedBridge Repair, (3) the Dresdner Instrument. Repairs were then subjected to a protocol of cyclic loading with 250 cycles at 1 Hz with 4different loading ranges applied: 20-100 N, 20-200 N, 20-300 N, and 20-400 N.
Results: After 250 cycles no significant differences in elongation were observed between the PARS, SpeedBridge or Dresdner Instrument repairs, with mean displacements of 18,4 ± 4,5, 11,8 ± 3,2 and 16,0 ± 1,9mm respectively. In comparison of all cycles the better part of elongation (77-85%) occurred within the first 10 cycles with an analog elongation in between 10-100 and 100-250 cycles. While all repairs survived the first 250 cycles of cyclic loading from 20 to 100 N, only the PARS and Midsubstance SpeedBridge Repair survived in bigger proportion (564 ± 59, 426 ± 115)
Conclusion: Within all minimal invasive repair groups early repair elongation was seen while the ultimate strengths of repairs (cycles to failure) were comparable across all techniques with slight deficiencies among the Dresdner Instrument group.
