The elastic capacity of a tendon-repair construct influences the force necessary to induce gapping.

Ateschrang, Atesch; Salewski, Christoph; Ahrend, Marc-Daniel; Schreiner, Anna Janine; Hirschmann, Michael T; Stöckle, Ulrich; Ahmad, Sufian S. (2019). The elastic capacity of a tendon-repair construct influences the force necessary to induce gapping. Knee surgery, sports traumatology, arthroscopy, 27(3), pp. 971-977. Springer-Verlag 10.1007/s00167-018-4972-9

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PURPOSE Most biomechanical investigations of tendon repairs were based on output measures from hydraulic loading machines, therefore, accounting for construct failure rather than true gapping within the rupture zone. It was hypothesized that the elastic capacity of a tendon-repair construct influences the force necessary to induce gapping. METHODS A tendon-repair model was created in 48 porcine lower hind limbs, which were allocated to three fixation techniques: (1) Krackow, (2) transosseous and (3) anchor fixation. Loading was performed based on a standardized phased load-to-failure protocol using a servohydraulic mechanical testing system MTS (Zwick Roell, Ulm, Germany). Rupture-zone dehiscence was measured with an external motion capture device. Factors influencing dehiscence formation was determined using a linear regression model and adjustment performed as necessary. A 3-mm gap was considered clinically relevant. Analysis of variance (ANOVA) was used for comparison between groups. RESULTS The elastic capacity of a tendon-repair construct influences the force necessary to induce gapping of 3 mm (F3mm) [β = 0.6, confidence interval (CI) 0.4-1.0, p < 0.001]. Furthermore, the three methods of fixation did not differ significantly in terms of maximum force to failure (n.s) or F3mm (n.s). CONCLUSION The main finding of this study demonstrated that the higher the elastic capacity of a tendon-repair construct, the higher the force necessary to induce clinically relevant gapping. LEVEL OF EVIDENCE Controlled biomechanical study.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Ahmad, Sufian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0942-2056

Publisher:

Springer-Verlag

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

05 Nov 2019 12:48

Last Modified:

05 Nov 2019 12:48

Publisher DOI:

10.1007/s00167-018-4972-9

PubMed ID:

29761212

Uncontrolled Keywords:

Achilles Anchor fixation Dehiscence Elasticity Elongation Failure Force Gap Gapping Krackow stitch PONTOS Repair Rupture Tear Tendon Transosseous fixation

BORIS DOI:

10.7892/boris.134137

URI:

https://boris.unibe.ch/id/eprint/134137

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