The Achillon® Achilles Tendon Repair: Is it Strong Enough?

Abstract

Background: Open repair of the Achilles tendon is associated with wound breakdown, infection and percutaneous methods risk sural nerve injury. The Achillon® mini-incision technique can reduce these risks and may provide the opportunity for early active rehabilitation. The aim of this study was to compare the strength of the Achillon® method with the commonly used Kessler method and to assess whether the strength of the repair was related to tendon diameter. Materials and Methods: Simulated ruptures in sheep Achilles tendons were repaired using either the Achillon® method or a two-strand Kessler technique with a No. 2 Ticron suture (Tyco Healthcare, UK). Each tendon diameter was measured, and matched for both groups. Specimens were loaded to failure using an Instron tensile testing machine (Instron Limited, UK). Results: Mean load to failure for the Achillon® repair was 153 N ± 60 (range, 65 to 270), and the mean load to failure for the Kessler Repair was 123 N ± 24 (range, 75 to 150). This difference was not statistically significant ( p = 0.21). There was a statistically significant higher mean load to failure for wider tendons repaired by the Achillon® method ( p = 0.05), however mean load to failure was not related to tendon width in Kessler repairs ( p = 0.23). Conclusion: This is the first study to compare these two methods of repair. The Achillon® repair has comparable tensile strength to the Kessler Repair. Clinical Relevance: The Achillon® repair appears to be a biomechanically sound method of repair for the acutely ruptured Achilles tendon.