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Biomechanical evaluation of tendon connection with novel suture techniques

Treść / Zawartość
Identyfikatory
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Achilles tendon rupture is a severe injury with poor curative effect due to its anatomical characteristic and mechanical peculiarity. Internal fixation of limited loop (IFLL) with steel-wire has been applied on patients with tendon rupture to fix the broken ends before physical rehabilitation. The purpose of this study is to investigate the biomechanical property and radiological characteristic of such suture technique for the repairment of tendon rupture. Methods: Tendons of pigs’ hint feet were separated for the biomechanical study. Suture surgery was performed according to the protocol of IFLL. Biomechanical Testing Machine was adopted to conduct the biomechanical tensile load examination. The maximal load, elastic modulus and tendon stiffness of the stitched tendons with or without reinforcement were examined. Results: The maximum tensile load of the stitched tendons using IFLL reached 1/4 of the uninjured tendon’s maximum tensile load, indicating that such suture technique is capable of providing enough tension for the ruptured tendon. Surprisingly, tendons fixed with titanium wire showed the highest load tension, which was comparable to the undamaged tendon. Therefore, we found the biomechanical basis of using IFLL in effectively connecting the rupture ends of tendons. Conclusions: In conclusion, we provide biomechanical evidence for the use of IFLL in treatment of Achilles tendon rupture, by providing enough strength for the ankle function. Such suture technique could help the patients with better rehabilitation and reduced in-hospital stay after Achilles tendon injury.
Rocznik
Strony
135--141
Opis fizyczny
Bibliogr. 23 poz., rys., wykr.
Twórcy
autor
  • Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
autor
  • Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
autor
  • Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
autor
autor
  • Biomechanics Lab, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
autor
  • Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
Bibliografia
  • [1] ANDRZEJEWSKI T., CZARNECKI P., DĄBROWSKI M., SPŁAWSKI R., ROGALA P., ROMANOWSKI L., Biomechanical properties of alternative suture technique for flexor tendon repair, Acta Bioeng. Biomech., 2017, 19(2), 167–172.
  • [2] BADALIHAN A., AIHEMAITI A., SHAWUTALI N., JIELILE J., JIALIHASI A., TANGKEJIE W. et al., Outcome of a one-stage tensile stress surgical technique and early postoperative rehabilitation in the treatment of neglected achilles tendon rupture, J. Foot Ankle Surg., 2015, 54(2), 153–159.
  • [3] BUKVIĆ N., KVESIĆ A., BREKALO Z., BOSAK A., BUKVIĆ F., KARLO R., The problem of post-traumatic varization of the distal end of the humerus remaining after the recovery of a supracondylar fracture, J. Pediatr. Orthop. B, 2013, 22, 372–375.
  • [4] CHEN SHIYI, JAMES H.-C. WANG, Basic and clinical research progress of the tendon, Chin. J. Sports Med., 2004, 23(3), 283–287.
  • [5] CHEN Z., WEI J.S., HOU Z.Y., HU J., CAO Y.G., CHEN Q.X., Application of internal fixation of steel-wire limited loop in early Achilles tendon rupture, Asian Pacific Journal of Tropical Medicine, 2013, 6(11), 902–907.
  • [6] CICCONE W.J. 2nd, BRATTON D.R., WEINSTEIN D.M., ELIAS J.J., Viscoelasticity and temperature variations decrease tension and stiffness of hamstring tendon grafts following anterior cruciate ligament reconstruction, J. Bone Joint Surg. Am., 2006, 88, 1071–1078.
  • [7] ERDEMIR A., HAMEL A.J., FAUTH A.R., PIAZZA S.J., SHARKEY N.A., Dynamic loading of the plantar aponeurosis in walking, J. Bone Joint Surg. Am., 2004, 86-A(3), 546–552.
  • [8] GIGANTE A., MOSCHINI A., VERDENELLI A., DEL TORTO M., ULISSE S., DE PALMA L., Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study, Knee Surg. Sports Traumatol. Arthrosc., 2008, 16(2), 204–209.
  • [9] GROETELAERS R.P., JANSSEN L., VAN DER VELDEN J., WIELAND A.W., AMENDT A.G., GEELEN P.H., JANZING H.M., Functional Treatment or Cast Immobilization After Minimally Invasive Repair of an Acute Achilles Tendon Rupture: Prospective, Randomized Trial. Foot Ankle Int., 2014, 35(8), 771–778.
  • [10] HAN X., GUO L2, WANG F., ZHU Q., YANG L., Contribution of PTHrP to mechanical strain-induced fibrochondrogenic differentiation in entheses of Achilles tendon of miniature pigs, J. Biomech., 2014, 47(10), 2406–2414.
  • [11] INGVAR J., TAGIL M., ENEROTH M., Nonoperative treatment of achilles tendon rupture: 196 consecutive patients with a 7% re-rupture rate, Acta Orthop., 2005, 76(4), 597–601.
  • [12] JALLAGEAS R., BORDES J., DAVIET J.C., MABIT C., COSTE C., Evaluation of surgical treatment for ruptured Achilles tendon in 31 athletes, Orthop. Traumatol. Surg. Res., 2013, 99(5), 577–584.
  • [13] JIELILE J., SABIRHAZI G., CHEN J., ALDYARHAN K., ZHEYIKEN J., ZHAO Q. et al., Novel surgical technique and early kinesiotherapy for acute Achilles tendon rupture, Foot Ankle Int., 2012, 33(12), 1119–1127.
  • [14] KANZ B.N., MORRIS R.P., LEWIS T., PANCHBHAVI V.K., Biomechanical evaluation of a knotless barbed suture repair in a human Achilles tendon rupture model, Foot Ankle Spec., 2014, 7(3), 176–181.
  • [15] LICHTWARK G.A., WILSON A.M., In vivo mechanical properties of the human Achilles tendon during one-legged hopping, J. Exp. Biol., 2005, 208(24), 4715–4725.
  • [16] LOHAN A., STOLL C., ALBRECHT M., DENNER A., JOHN T., KRÜGER K. et al., Human hamstring tenocytes survive when seeded into a decellularized porcine Achilles tendon extracellular matrix, Connect Tissue Res., 2013, 54(4–5), 305–312.
  • [17] NAGASAWA K., NOGUCHI M., IKOMA K., KUBO T., Static and dynamic biomechanical properties of the regenerating rabbit Achilles tendon, Clin. Biomech. (Bristol, Avon)., 2008, 23(6), 832–838.
  • [18] NURMI J.T., KANNUS P., SIEVÄNEN H., JÄRVELÄ T., JÄRVINEN M., JÄRVINEN T.L., Interference screw fixation of soft tissue grafts in anterior cruciate ligament reconstruction: Part 2, Effect of preconditioning on graft tension during and after screw insertion, Am. J. Sports Med., 2004, 32, 418–424.
  • [19] SOROCEANU A., SIDHWA F., AARABI S., KAUFMAN A., GLAZEBROOK M., Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials, J. Bone Joint Surg. Am., 2012, 94(23), 2136–2143.
  • [20] STRICKLAND J.W., Flexor tendon injuries: II. Operative technique, J. Am. Acad. Orthop. Surg., 1995, 3(1), 55–62.
  • [21] TUCKER J.J., GORDON J.A., ZANES R.C., ZUSKOV A., VINCIGUERRA J.D., BLOEBAUM R.D. et al., P2 porous titanium implants improve tendon healing in an acute rat supraspinatus repair model, J. Shoulder Elbow. Surg., 2017, 26, 529–535.
  • [22] TUDISCO C., BISICCHIA S., Reconstruction of neglected traumatic Achilles tendon rupture in a young girl, J. Orthop. Traumatol., 2012, 13, 163–166.
  • [23] WANG G., XU Y., ZHANG L., YE D., FENG X., FU T. et al., Enhancement of Apoptosis by Titanium Alloy Internal Fixations during Microwave Treatments for Fractures: An Animal Study, PLoS One, 2015, 10, e0132046.
Uwagi
Opracowanie rekordu w ramach umowy 509/P-DUN/2018 ze środków MNiSW przeznaczonych na działalność upowszechniającą naukę (2018).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-112dcedb-7d68-4f74-aeb4-68f848765d72
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