Biomechanical comparison of the primary stability of suturing Achilles tendon rupture: a cadaver study of Bunnell and Kessler techniques under cyclic loading conditions
Biomechanical comparison of the primary stability of suturing Achilles tendon rupture: a cadaver study of Bunnell and Kessler techniques under cyclic loading conditions
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DOI：
10.1007/s00402-008-0602-1
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发表时间：
2008-11-01
影响因子：
2.3
通讯作者：
Petersen, Wolf
中科院分区：
文献类型：
--
作者：
Herbort, Mirco;Haber, Axel;Petersen, Wolf
生物力学研究研究了跟腱修复的缝合技术，使用单载荷到失效试验来评估修复结构的最大载荷能力。在早期康复过程中，修复是重复性的，如锻炼或日常生活活动，如散步。循环加载似乎比单循环破坏试验更接近生理加载条件。本研究的目的是测试循环载荷条件下最常用的跟腱修复技术（Bunnell和Kessler修复）。材料与方法采用Bunnell或Kessler技术缝合新鲜人尸体肌腱。修复后，使用Lloyd LR-5K Plus单轴生物力学试验机进行循环加载试验。两组均采用0.7 mm PDS缝合。结果除最大载荷外，Bunnell法与Kessler法缝合肌腱间无明显差异。在循环测试期间，两组之间在位移方面没有差异。这也适用于结构的刚度，我们定义了从负载到失效测量。两组失效模式不同；采用Kessler技术修复的肌腱被肌腱切开，Bunnell组的缝合材料撕裂。结论在我们的研究中，Bunnell和Kessler技术在使用相同的C缝合材料时表现出相似的生物力学性能。Bunnell技术的典型失效模式显示了通过使用更强的缝合材料来优化生物力学行为的潜力。
Introduction Biomechanical studies investigating suture techniques for Achilles tendon repair used single load to failure tests in order to evaluate the maximal load capacity of the repaired construct. During early rehabilitation the repair is repetitively loaded Such as exercise or daily living activities like walking. Cyclic loading seems to duplicate the physiological loading conditions more closely than single cycle failure tests. Aim of this study was to test the most commonly used Achilles tendon repair techniques (Bunnell and Kessler repair) under cyclic loading conditions.Materials and methods Following tenotomy fresh human cadaveric tendons were sutured either with the Bunnell or Kessler technique. After repair, cyclic loading tests were performed with a uniaxial biomechanical testing machine Lloyd LR-5K Plus. Both groups were Sutured with 0.7 mm PDS.Results Except at maximum load we could not find significant differences between tendons sutured by Bunnell and Kessler techniques. During the cyclic testing there were no differences between both groups with respect to displacement. This applies also to the stiffness of the constructs, which we defined from the load to failure measurements. The failure modes in both groups differed; the tendons repaired by Kessler technique were Cut by the tendons and in the Bunnell group the suture material tore in each specimen tested.Conclusion In our study Bunnell and Kessler techniques showed similar biomechanical properties using the same C suture material. The typical failure mode of the Bunnell technique shows potential to optimise biomechanical behavior by using stronger suture material.