Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position
Background The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may opt...
Gespeichert in:
| Veröffentlicht in: | Foot and ankle specialist 2022-02, Vol.15 (1), p.67-75 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 75 |
|---|---|
| container_issue | 1 |
| container_start_page | 67 |
| container_title | Foot and ankle specialist |
| container_volume | 15 |
| creator | Stake, Ingrid K. Miles, Jon W. Douglass, Brenton W. Dornan, Grant J. Clanton, Thomas O. |
| description | Background
The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair.
Methods
Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane. The anchors were tensioned according to a protocol representing progressive, postoperative rehabilitation. Load, number of loading cycles, displacement, and mode of failure were recorded.
Results
With the anchors placed at 45°, 90°, and 135°, the ultimate failure loads were mean 265 ± 64 N, 264 ± 75 N, and 279 ± 40 N, and the total number of loading cycles were mean 459 ± 166, 466 ± 158, and 469 ± 110, respectively. The effect of anchor angle on failure load, number of loading cycles, and displacement was not statistically significant. Visually, the anchors at 45° and 90° demonstrated sutures cutting through the bone.
Conclusion
We found no statistically significant difference in pullout strength between the 3 different anchor angles. Sutures cutting through the bone may be a concern with acute anchor angles. This suggests that a 135° anchor angle may result in a lower risk of tendon elongation with the percutaneous knotless repair technique.
Levels of Evidence
Cadaveric laboratory study |
| doi_str_mv | 10.1177/19386400211009360 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2543444353</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_19386400211009360</sage_id><sourcerecordid>2543444353</sourcerecordid><originalsourceid>FETCH-LOGICAL-c292t-55eb904f5373399a2861d6d43f6d7cab2e4487671bc30256543f62d63312f34e3</originalsourceid><addsrcrecordid>eNp9kEtPwzAQhC0EouXxA7ggH7mk-BWn4Vaq8pCKQKicI8fZNK6cuNgJEv-ehBYuSJxmtfvNSDsIXVAyoTRJrmnKp1IQwiglJOWSHKDxsIsSyeXhfh6AEToJYUOIJFLIYzTiggoWJ3yMzK1xNehKNUYrixcfynaqNa7BrsQzXRlrIeAVNEW_ejJF6PLQqkYDfoWtMv4GryrAi7IE3YZvT6Mr53tZW8CqKfCLC2YIPENHpbIBzvd6it7uFqv5Q7R8vn-cz5aRZilroziGPCWijHnCeZoqNpW0kIXgpSwSrXIGQkwTmdBcc8JiGQ8XVkjOKSu5AH6Krna5W-_eOwhtVpugwVrVgOtCxnqHEILHvEfpDtXeheChzLbe1Mp_ZpRkQ8PZn4Z7z-U-vstrKH4dP5X2wGQHBLWGbOM63_Tv_pP4BRMOga4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2543444353</pqid></control><display><type>article</type><title>Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position</title><source>Access via SAGE</source><source>MEDLINE</source><creator>Stake, Ingrid K. ; Miles, Jon W. ; Douglass, Brenton W. ; Dornan, Grant J. ; Clanton, Thomas O.</creator><creatorcontrib>Stake, Ingrid K. ; Miles, Jon W. ; Douglass, Brenton W. ; Dornan, Grant J. ; Clanton, Thomas O.</creatorcontrib><description>Background
The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair.
Methods
Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane. The anchors were tensioned according to a protocol representing progressive, postoperative rehabilitation. Load, number of loading cycles, displacement, and mode of failure were recorded.
Results
With the anchors placed at 45°, 90°, and 135°, the ultimate failure loads were mean 265 ± 64 N, 264 ± 75 N, and 279 ± 40 N, and the total number of loading cycles were mean 459 ± 166, 466 ± 158, and 469 ± 110, respectively. The effect of anchor angle on failure load, number of loading cycles, and displacement was not statistically significant. Visually, the anchors at 45° and 90° demonstrated sutures cutting through the bone.
Conclusion
We found no statistically significant difference in pullout strength between the 3 different anchor angles. Sutures cutting through the bone may be a concern with acute anchor angles. This suggests that a 135° anchor angle may result in a lower risk of tendon elongation with the percutaneous knotless repair technique.
Levels of Evidence
Cadaveric laboratory study</description><identifier>ISSN: 1938-6400</identifier><identifier>EISSN: 1938-7636</identifier><identifier>DOI: 10.1177/19386400211009360</identifier><identifier>PMID: 34142573</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Achilles Tendon - surgery ; Biomechanical Phenomena ; Cadaver ; Humans ; Suture Anchors ; Suture Techniques ; Sutures</subject><ispartof>Foot and ankle specialist, 2022-02, Vol.15 (1), p.67-75</ispartof><rights>2021 The Author(s)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c292t-55eb904f5373399a2861d6d43f6d7cab2e4487671bc30256543f62d63312f34e3</cites><orcidid>0000-0003-0048-8897 ; 0000-0001-9831-7484 ; 0000-0001-8410-7718</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/19386400211009360$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/19386400211009360$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21824,27929,27930,43626,43627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34142573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stake, Ingrid K.</creatorcontrib><creatorcontrib>Miles, Jon W.</creatorcontrib><creatorcontrib>Douglass, Brenton W.</creatorcontrib><creatorcontrib>Dornan, Grant J.</creatorcontrib><creatorcontrib>Clanton, Thomas O.</creatorcontrib><title>Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position</title><title>Foot and ankle specialist</title><addtitle>Foot Ankle Spec</addtitle><description>Background
The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair.
Methods
Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane. The anchors were tensioned according to a protocol representing progressive, postoperative rehabilitation. Load, number of loading cycles, displacement, and mode of failure were recorded.
Results
With the anchors placed at 45°, 90°, and 135°, the ultimate failure loads were mean 265 ± 64 N, 264 ± 75 N, and 279 ± 40 N, and the total number of loading cycles were mean 459 ± 166, 466 ± 158, and 469 ± 110, respectively. The effect of anchor angle on failure load, number of loading cycles, and displacement was not statistically significant. Visually, the anchors at 45° and 90° demonstrated sutures cutting through the bone.
Conclusion
We found no statistically significant difference in pullout strength between the 3 different anchor angles. Sutures cutting through the bone may be a concern with acute anchor angles. This suggests that a 135° anchor angle may result in a lower risk of tendon elongation with the percutaneous knotless repair technique.
Levels of Evidence
Cadaveric laboratory study</description><subject>Achilles Tendon - surgery</subject><subject>Biomechanical Phenomena</subject><subject>Cadaver</subject><subject>Humans</subject><subject>Suture Anchors</subject><subject>Suture Techniques</subject><subject>Sutures</subject><issn>1938-6400</issn><issn>1938-7636</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPwzAQhC0EouXxA7ggH7mk-BWn4Vaq8pCKQKicI8fZNK6cuNgJEv-ehBYuSJxmtfvNSDsIXVAyoTRJrmnKp1IQwiglJOWSHKDxsIsSyeXhfh6AEToJYUOIJFLIYzTiggoWJ3yMzK1xNehKNUYrixcfynaqNa7BrsQzXRlrIeAVNEW_ejJF6PLQqkYDfoWtMv4GryrAi7IE3YZvT6Mr53tZW8CqKfCLC2YIPENHpbIBzvd6it7uFqv5Q7R8vn-cz5aRZilroziGPCWijHnCeZoqNpW0kIXgpSwSrXIGQkwTmdBcc8JiGQ8XVkjOKSu5AH6Krna5W-_eOwhtVpugwVrVgOtCxnqHEILHvEfpDtXeheChzLbe1Mp_ZpRkQ8PZn4Z7z-U-vstrKH4dP5X2wGQHBLWGbOM63_Tv_pP4BRMOga4</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Stake, Ingrid K.</creator><creator>Miles, Jon W.</creator><creator>Douglass, Brenton W.</creator><creator>Dornan, Grant J.</creator><creator>Clanton, Thomas O.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0048-8897</orcidid><orcidid>https://orcid.org/0000-0001-9831-7484</orcidid><orcidid>https://orcid.org/0000-0001-8410-7718</orcidid></search><sort><creationdate>202202</creationdate><title>Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position</title><author>Stake, Ingrid K. ; Miles, Jon W. ; Douglass, Brenton W. ; Dornan, Grant J. ; Clanton, Thomas O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c292t-55eb904f5373399a2861d6d43f6d7cab2e4487671bc30256543f62d63312f34e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Achilles Tendon - surgery</topic><topic>Biomechanical Phenomena</topic><topic>Cadaver</topic><topic>Humans</topic><topic>Suture Anchors</topic><topic>Suture Techniques</topic><topic>Sutures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stake, Ingrid K.</creatorcontrib><creatorcontrib>Miles, Jon W.</creatorcontrib><creatorcontrib>Douglass, Brenton W.</creatorcontrib><creatorcontrib>Dornan, Grant J.</creatorcontrib><creatorcontrib>Clanton, Thomas O.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Foot and ankle specialist</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stake, Ingrid K.</au><au>Miles, Jon W.</au><au>Douglass, Brenton W.</au><au>Dornan, Grant J.</au><au>Clanton, Thomas O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position</atitle><jtitle>Foot and ankle specialist</jtitle><addtitle>Foot Ankle Spec</addtitle><date>2022-02</date><risdate>2022</risdate><volume>15</volume><issue>1</issue><spage>67</spage><epage>75</epage><pages>67-75</pages><issn>1938-6400</issn><eissn>1938-7636</eissn><abstract>Background
The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair.
Methods
Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane. The anchors were tensioned according to a protocol representing progressive, postoperative rehabilitation. Load, number of loading cycles, displacement, and mode of failure were recorded.
Results
With the anchors placed at 45°, 90°, and 135°, the ultimate failure loads were mean 265 ± 64 N, 264 ± 75 N, and 279 ± 40 N, and the total number of loading cycles were mean 459 ± 166, 466 ± 158, and 469 ± 110, respectively. The effect of anchor angle on failure load, number of loading cycles, and displacement was not statistically significant. Visually, the anchors at 45° and 90° demonstrated sutures cutting through the bone.
Conclusion
We found no statistically significant difference in pullout strength between the 3 different anchor angles. Sutures cutting through the bone may be a concern with acute anchor angles. This suggests that a 135° anchor angle may result in a lower risk of tendon elongation with the percutaneous knotless repair technique.
Levels of Evidence
Cadaveric laboratory study</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>34142573</pmid><doi>10.1177/19386400211009360</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0048-8897</orcidid><orcidid>https://orcid.org/0000-0001-9831-7484</orcidid><orcidid>https://orcid.org/0000-0001-8410-7718</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1938-6400 |
| ispartof | Foot and ankle specialist, 2022-02, Vol.15 (1), p.67-75 |
| issn | 1938-6400 1938-7636 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2543444353 |
| source | Access via SAGE; MEDLINE |
| subjects | Achilles Tendon - surgery Biomechanical Phenomena Cadaver Humans Suture Anchors Suture Techniques Sutures |
| title | Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-14T21%3A40%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Biomechanical%20Evaluation%20of%20Achilles%20Tendon%20Midsubstance%20Repair:%20The%20Effects%20of%20Anchor%20Angle%20and%20Position&rft.jtitle=Foot%20and%20ankle%20specialist&rft.au=Stake,%20Ingrid%20K.&rft.date=2022-02&rft.volume=15&rft.issue=1&rft.spage=67&rft.epage=75&rft.pages=67-75&rft.issn=1938-6400&rft.eissn=1938-7636&rft_id=info:doi/10.1177/19386400211009360&rft_dat=%3Cproquest_cross%3E2543444353%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2543444353&rft_id=info:pmid/34142573&rft_sage_id=10.1177_19386400211009360&rfr_iscdi=true |