Biomechanical comparison of four methods of repair of the Achilles tendon

C. Ortiz, E. Wagner, P. Mocoçain, G. Labarca, A. Keller, A. Del Buono, N. Maffulli

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37 Scopus citations


We tested four types of surgical repair for load to failure and distraction in a bovine model of Achilles tendon repair. A total of 20 fresh bovine Achilles tendons were divided transversely 4 cm proximal to the calcaneal insertion and randomly repaired using the Dresden technique, a Krackow suture, a triple-strand Dresden technique or a modified oblique Dresden technique, all using a Fiberwire suture. Each tendon was loaded to failure. The force applied when a 5 mm gap was formed, peak load to failure, and mechanism of failure were recorded. The resistance to distraction was significantly greater for the triple technique (mean 246.1 N (205 to 309) to initial gapping) than for the Dresden (mean 180 N (152 to 208); p = 0.012) and the Krackow repairs (mean 101 N (78 to 112; p < 0.001). Peak load to failure was significantly greater for the triple-strand repair (mean 675 N (453 to 749)) than for the Dresden (mean 327.8 N (238 to 406); p < 0.001), Krackow (mean 223.6 N (210 to 252); p < 0.001) and oblique repairs (mean 437.2 N (372 to 526); p < 0.001). Failure of the tendon was the mechanism of failure for all specimens except for the tendons sutured using the Krackow technique, where the failure occurred at the knot.
Original languageAmerican English
Pages (from-to)663-667
Number of pages5
JournalJournal of Bone and Joint Surgery - Series B
Volume94 B
Issue number5
StatePublished - 1 May 2012
Externally publishedYes


  • Achilles Tendon
  • Animals
  • Cattle
  • Disease Models, Animal
  • Rupture
  • Suture Techniques
  • Tendon Injuries
  • Tensile Strength
  • Weight-Bearing


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