Abstract
The jigless knotless internal brace surgery (JKIB), an alternative method for minimal
invasive surgery (MIS) repair of acute Achilles tendon rupture, has advantages of
preventing sural-nerve injury in MIS and superficial wound infection in open surgery,
as previous clinical research demonstrates. However, no comparative study on the biomechanical
performance between JKIB and other MIS techniques has been reported until now. In
this study, 50 fresh porcine Achilles tendons were used to compare the JKIB with open
surgery (two-stranded Krachow suture) with other MIS techniques, including Percutaneus
Achilles Repair System (PARS), Speedbridge (SB), and Achillon Achilles Tendon Suture
System (ACH), using a biomechanical testing with cyclic loading at 1 Hz. This test
was used to simulate a progressive rehabilitation protocol where 20 to 100 N was applied
in the first 250 cycles, followed by 20 to 190 N in the second 250 cycles, and then
20 to 369 N in the third 250 cycles. The cyclic displacement after 10, 100 and 250
cycles were recorded. The survived cycles were defined as a sudden drop in measured
load. In survived cycles, the JKIB group (552.3 ± 72.8) had significantly higher cycles
than the open, PARS, and ACH groups (204.3 ± 33.3, 395.9 ± 96.0, and 397.1 ± 80.9,
respectively, p < .01) as analyzed by post hoc analysis, but no significant difference as compared
with the SB group (641.6 ± 48.7). In cyclic displacement after 250 cyclic loadings,
the JKIB group (11.29 ± 1.29) showed no significant difference as compared with PARS,
SB, and ACH groups (12.21 ± 1.18, 9.80 ± 0.80, and 11.57 ± 1.10 mm, respectively)
and significant less displacement than the open group (14.50 ± 1.85, p < .01). These findings suggest that JKIB could be an option for acute Achilles tendon
repair in the MIS fashion due to no larger cyclic elongation compared with other MIS
techniques.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: April 02, 2022
Footnotes
Conflict of Interest: The authors declare that they have no competing interests.
Funding Disclosure: This study was supported by grant MOST108-2314-B-006-011-MY2 from the National Science Council, Taiwan, and grant NCKUH-10904016 from the National Cheng Kung University Hospital, Tainan, Taiwan
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