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Initial stability of two different adhesives compared to suture repair for acute Achilles tendon rupture—A biomechanical evaluation

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Abstract

Purpose

Treatment of acute subcutaneous Achilles tendon rupture remains challenging. Whereas the results of conservative and operative treatment are inconsistent, early mobilisation treatment seems to be beneficial. Besides suture repair, operative treatment using adhesives reveals promising results. Our hypothesis was that a gluing technique provides initial stability comparable to sutures.

Methods

In a biomechanical study, 18 fresh frozen sheep Achilles tendons were used to compare the biomechanical properties of suture repair using PDS® II and Bunnell’s technique to tendon gluing using BioGlue® and Tissucol®. Load to failure testing was performed.

Results

Ultimate failure loads of sutures (146.2 ± 30.8 N) are significantly superior to the techniques using BioGlue® (38.4 ± 18.3 N; p <0.0001) or Tissucol® (4.7 ± 2.5 N; p <0.0001). Interestingly, no significant differences in stiffness were found between the application of BioGlue® and PDS® II.

Conclusions

Suture repair provides significantly superior biomechanical properties compared to the use of both tested adhesives BioGlue® and Tissucol®. Based on the presented data we recommend the use of suture material for open Achilles tendon repair.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Trauma and Hand Surgery, Heinrich Heine University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany

    Johannes Schneppendahl, Simon Thelen, Alberto Schek, Ioana Bala, Mohssen Hakimi, Jan-Peter Grassmann, Joachim Windolf & Michael Wild

  2. Department of Anatomy II, University of Cologne, Joseph-Stelzmann Str.9, 50931, Cologne, Germany

    Christian Eichler

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  1. Johannes Schneppendahl
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  2. Simon Thelen
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  3. Alberto Schek
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  8. Joachim Windolf
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  9. Michael Wild
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Correspondence to Simon Thelen.

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Schneppendahl, J., Thelen, S., Schek, A. et al. Initial stability of two different adhesives compared to suture repair for acute Achilles tendon rupture—A biomechanical evaluation. International Orthopaedics (SICOT) 36, 627–632 (2012). https://doi.org/10.1007/s00264-011-1357-9

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  • DOI: https://doi.org/10.1007/s00264-011-1357-9

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