Surgical treatment of Achilles tendon rupture

Abstract

Background The mechanical properties of present-day percutaneous repairs of Achilles tendon ruptures are not known. Material and methods Artificially-created ruptures in 24 human cadaveric Achilles tendons were repaired with an open Bunnell repair, a percutaneous calcaneal tunnel or a percutaneous bone-anchor repair. In the open technique no.1 PDS-II absorbable suture material was used, and in the percutaneous techniques either no.1 PDS-II or no.1 Panacryl absorbable suture material was used. The specimens were tested in a materials testing machine until failure occurred. Results The common mode of failure was suture breakage in non-anchor repairs, and anchor pullout in anchor repairs. The average strength of the repairs varied from 166 N (SD 60) to 211 N (SD 30), with no differences between the techniques (p = 0.5). Interpretation Taking costs into account, the percutaneous calcaneal tunnel technique and the open technique are the methods of choice.