Evaluation of tendon-to-bone reattachment: a rabbit model

Two different tendon-to-bone reattachment methods were compared to assess tensile strength and histologic repair. After sharp dissection, rabbit Achilles tendons were reattached to the calcaneus by one of two methods: to abraded cortical bone (group 1) or into a cancellous bone tunnel (group 2). After surgery, each rabbit had its long-leg hip spica-cast in plantar flexion for 3 weeks. The rabbits' tendon-bone junctions were harvested 1, 2, 4, 6, and 12 weeks after surgery. Three rabbits were used for each repair method at each point in time: 2 for strength testing and 1 for histologic analysis. After this preliminary study, tensile strength was tested with another 14 rabbits 2 weeks after surgery. At each advancing point in time, in both groups, increasing tendon-bone strength was found. Ultimate tensile strength was equivalent for test rabbits (both methods after 6 weeks) and control rabbits. There was no significant difference between methods at any point in time. Blinded pathologic evaluation reported similar healing with both methods over time. With both methods, healing occurred with Sharpey fibers attached to the superficial cortex, with tendon resorption occurring in the bone tunnel. The simple method of cortical reattachment was shown to be equal to the more complex bone-tunnel reattachment.