Jigless knotless internal brace versus other open Achilles tendon repairs using a progressive rehabilitation protocol: a biomechanical study

Po Yen Ko, Chieh Hsiang Hsu, Chih Kai Hong, Ming Tung Hung, Wei Ren Su, Po Ting Wu, I. Ming Jou, Fong Chin Su

研究成果: Article同行評審

3 引文 斯高帕斯(Scopus)

摘要

Background: The jigless knotless internal brace surgery (JKIB), a modified minimal invasive surgery (MIS) for acute Achilles tendon injury, has advantages of preventing sural-nerve injury in MIS and superficial wound infection in open surgery, as demonstrated in previous clinical research. However, to date, biomechanical testing has not yet been validated. Materials and methods: Sixty fresh porcine Achilles tendons were used to compare the JKIB with other open surgery techniques, the four-stranded Krackow suture (4sK) and the triple-bundle suture (TBS) in biomechanical testing with cyclic loading set at 1 Hz. This approach simulated a progressive rehabilitation protocol where 20-100 N was applied in the first 1000 cycles, followed by 20-190 N in the second 1000 cycles, and then 20-369 N in the third 1000 cycles. The cycles leading to repair gaps of 2 mm, 5 mm, and 10 mm were recorded. The survival cycles were defined as repair gap of 10 mm. Results: With respect to survival cycles, a significant difference was found among the three groups, in which the TBS was the most robust, followed by the JKIB and the 4sK, where the mean survived cycles were 2639.3 +/− 263.55, 2073.6 +/− 319.92, and 1425.25 +/− 268.96, respectively. Significant differences were verified via a post hoc analysis with the Mann–Whitney U test after the Bonferroni correction (p < 0.017). Conclusions: The TBS was the strongest suture structure in acute Achilles tendon repair. However, the JKIB could be an option in acute Achilles tendon repair with the MIS technique due to it being more robust than the 4sK, which has been typically favored for use in open repair.

原文English
文章編號908
期刊BMC Musculoskeletal Disorders
22
發行號1
DOIs
出版狀態Published - 2021 12月

All Science Journal Classification (ASJC) codes

  • 風濕病
  • 骨科和運動醫學

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