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Biomechanical and histologic comparison of Achilles tendon ruptures reinforced with intratendinous and peritendinous plantaris tendon grafts in rabbits: an experimental study

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Abstract

Introduction

We hypothesized that the closer the reinforcing graft was to the repair zone, the more strength the healed tendon would achieved. Therefore, we compared the ruptured rabbit Achilles tendons reinforced with intratendinous and peritendinous plantaris grafts.

Materials and methods

The experimental study was performed on Achilles tendons of 20 rabbits. First, they were divided into two groups: group I (n=10) underwent intratendinous graft and end-to-end tenorraphy, and group P (n=10) were repaired end-to-end and then reinforced with a peritendinous plantaris graft. An above-knee cast was applied during 6 weeks postoperatively. The two groups were compared to each other biomechanically and histologically. Seven randomly selected rabbits from each group were used for biomechanical evaluation. The remaining six rabbits (three from each group) were used for histologic comparison. Non-operated sides (n=20) served as the control group.

Results

The mean maximum load at rupture of the repaired and control groups was 159.9±31 N, 83±7.5 N, and 207.5±35 N for group I, group P, and the control group, respectively. Values between groups were significantly different considering maximum load and absorbed energy to rupture. There was no significant difference between groups I and P in respect to strain. Control group tendons (groups I-C and P-C) had significantly more lengthening capability than operated tendons. Macroscopically, group I tendons were thicker and stiffer than group P tendons. Histologically, differences between the group I and group P specimens revealed that the healing process was faster in tendons augmented intratendinously.

Conclusions

In reinforcing Achilles tendon repair, the site of the tendon graft affected the result. When the graft was used intratendinously, the healed tendon was more similar biomechanically to normal tendon and had more graft-tendon orientation histologically than the tendon augmented peritendinously.

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Authors and Affiliations

  1. Orthopedics and Traumatology Department, Faculty of Medicine, Kocatepe University, Afyon, Turkey

    Kuru Ilhami, Maralcan Gokhan, Bozan M. Eray & Altınel Levent

  2. Umit Sitesi 31/9 Umitkoy, 06530, Ankara, Turkey

    Kuru Ilhami

  3. Orthopedics and Traumatology Department, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey

    Inan Ulukan

  4. Pathology Department, Faculty of Medicine, Kocatepe University, Afyon, Turkey

    Tokyol Çiğdem

Authors
  1. Kuru Ilhami
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  2. Maralcan Gokhan
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  3. Inan Ulukan
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  4. Bozan M. Eray
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  5. Altınel Levent
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  6. Tokyol Çiğdem
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Corresponding author

Correspondence to Kuru Ilhami.

Additional information

This study was performed at the Biomechanic Laboratory of Middle East Technical University (METU) and Animal Experimental Research Laboratory of Osmangazi University in Turkey. The experiments comply with the current law of our country

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Ilhami, K., Gokhan, M., Ulukan, I. et al. Biomechanical and histologic comparison of Achilles tendon ruptures reinforced with intratendinous and peritendinous plantaris tendon grafts in rabbits: an experimental study. Arch Orthop Trauma Surg 124, 608–613 (2004). https://doi.org/10.1007/s00402-003-0626-5

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  • DOI: https://doi.org/10.1007/s00402-003-0626-5

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