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Published in: Journal of Orthopaedics and Traumatology 3/2017

Open Access 01-09-2017 | Original Article

Interlocking horizontal mattress suture versus Kakiuchi technique in repair of Achilles tendon rupture: a biomechanical study

Authors: Matteo Guzzini, Riccardo Maria Lanzetti, Lorenzo Proietti, Daniele Mazza, Mattia Fabbri, Edoardo Monaco, Germano Ferri, Andrea Ferretti

Published in: Journal of Orthopaedics and Traumatology | Issue 3/2017

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Abstract

Background

In recent years, the type of surgical treatment for Achilles tendon rupture has been the subject of controversial debate. This biomechanical study evaluates for the first time in literature the ultimate failure load (UFL) of interlocking horizontal mattress (IHM) suture as compared with Kakiuchi suture in Achilles tendon rupture. The hypothesis is that IHM suture can be performed also for Achilles tendon rupture and ensures higher resistance compared with the traditional Kakiuchi suture.

Materials and methods

Twenty fresh bovine Achilles tendons were obtained. Ten preparations were randomly assigned to each of two different groups: group A (10 specimens) sutured by IHM technique, and group B (10 specimens) sutured by Kakiuchi technique. Each construct was mounted and fixed on a tensile testing machine. Static preconditioning of 50 N was applied for 5 min as initial tensioning to stabilize the mechanical properties of the graft, then a load to failure test was performed at crosshead speed of 500 mm/min.

Results

Ten specimens were tested for each group. The mean UFL was 228.6 ± 98.6 N in the IHM suture group and 96.57 ± 80.1 N in the Kakiuchi suture group. Statistical analysis showed a significant difference (p < 0.05) with better UFL in the IHM group. In both groups, the failure mode registered in each specimen was suture breakage (rupture of suture thread).

Conclusions

IHM suture achieved better UFL compared with Kakiuchi suture in an animal model of Achilles tendon repair. These results seem to support IHM as a valid option in Achilles tendon rupture.
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Metadata
Title
Interlocking horizontal mattress suture versus Kakiuchi technique in repair of Achilles tendon rupture: a biomechanical study
Authors
Matteo Guzzini
Riccardo Maria Lanzetti
Lorenzo Proietti
Daniele Mazza
Mattia Fabbri
Edoardo Monaco
Germano Ferri
Andrea Ferretti
Publication date
01-09-2017
Publisher
Springer International Publishing
Published in
Journal of Orthopaedics and Traumatology / Issue 3/2017
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI
https://doi.org/10.1007/s10195-017-0455-x

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