Summary

Both krackow and uchiyama tendon repair technique had similar maximum load to failure (119.18N ± 37.4 [Krackow} versus 112.98 ± 32.06 [Uchiyama], p=0.34) of an acute tendon rupture in an ex vivo porcine model. Uchiyama suture technique may be an alternative to open repair of acute tendon of Achilles rupture.

Abstract

Introduction

Achilles tendon rupture is a common injury in athletes and active individuals. In 2007, Uchiyama and colleagues published a case series of a modified operation for Achilles tendon ruptures. This technique is reported to allow strong repair stability and subsequent early weight bearing and range of motion exercises. However, no biomechanical studies have been done to compare this novel suturing technique to a standard like krackow suture technique. Objective: This study compared the biomechanical property (maximum load to failure) of krackow and uchiyama tendon repair technique in an acute tendon rupture in an ex vivo porcine model. Methodology: Twenty freshly harvested porcine flexor digitorum longus tendons were transected transversely at the mid-substance. Ten were repaired with double strand Krackow suture technique using Ethibond®2. The other 10 tendons were further divided into bundles approximately 5mm wide - 2 proximal and 2 distal. The Uchiyama repair was completed by gathering each bundle by Bunnell sutures using Ethibond®2-0. Biomechanical testing conducted on the samples using a mechanical universal testing machine (Shimadzu® AGS-X Series). Longitudinal traction at an advancement rate of 0.85mm/s was done and maximal load to failure was noted. Results: The average maximum load to failure was not significantly different between the Krackow repair [119.18N ± 37.4] and Uchiyama [112.98 ± 32.06] (p=0.34). All modes of failure were due to suture breakage. Conclusion: There is no significant difference between the load to failure of Uchiyama and Krackow suture technique. Uchiyama suture technique may be an alternative to open repair of acute tendon of Achilles rupture.