International Orthopaedics

, Volume 36, Issue 9, pp 1947–1951 | Cite as

Initial Achilles tendon repair strength—synthesized biomechanical data from 196 cadaver repairs

  • Patrick SadoghiEmail author
  • Claudio Rosso
  • Victor Valderrabano
  • Andreas Leithner
  • Patrick Vavken
Original Paper



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.


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.


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.


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.


Achilles Tendon Suture Material Acute Achilles Tendon Rupture Core Suture Repair Strength 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Patrick Sadoghi
    • 1
    • 2
    Email author
  • Claudio Rosso
    • 3
    • 4
  • Victor Valderrabano
    • 3
  • Andreas Leithner
    • 2
  • Patrick Vavken
    • 1
    • 5
  1. 1.Sports Medicine Research Laboratory, Department of Orthopedic Surgery, Children’s Hospital BostonHarvard Medical SchoolBostonUSA
  2. 2.Department of Orthopaedic SurgeryMedical University of GrazGrazAustria
  3. 3.Department of Orthopaedic SurgeryUniversity Hospital BaselBaselSwitzerland
  4. 4.Center for Advanced Orthopaedic StudiesBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonUSA
  5. 5.Harvard Center for Population and Development StudiesHarvard School of Public HealthBostonUSA

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