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Updated: Jul 15, 2026
A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
Mechanical evaluation of different techniques for Achilles tendon repair
Matthias Gebauer1, Frank Timo Beil, Johannes Beckmann
1Department of Trauma, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246, Hamburg, Germany. mgebauer@uke.uni-hamburg.de
Introduction:
One aim of the surgical treatment of acute Achilles tendon ruptures is to obtain a maximum primary stability of the sutured tendon. Therefore, we investigated the primary stability of sutured human Achilles tendons depending on different applied techniques.
Methods:
The strength of 60 repaired cadaveric human Achilles tendons was tested depending on either the suture technique (Bunnell or Kessler), the suture material (PDS-thread or PDS-cord) or an additional plantaris tendon augmentation (PDS-thread with or without augmentation). Following anatomic reconstruction the repaired specimens were loaded to failure.
Results:
The use of Bunnell's technique resulted in a stronger primary suture stability compared to Kessler's technique. Sutures carried out with a PDS-thread were of lower strength than those accomplished with a PDS-cord (Bunnell: thread 139 N +/- 29.8; cord 291 N +/- 55.2/Kessler: thread 137 N +/- 37.3; cord 180 N +/- 41.1). Sutures performed according to Bunnell's technique with a PDS-thread and an additional autologous plantaris tendon augmentation reached the highest primary stability (326 N +/- 124.9).
Conclusions:
The findings identify the Achilles tendon suture with a PDS-cord according to Bunnell's technique as a mechanically strong method. A plantaris tendon augmentation in addition to a PDS-thread can even add more stability to the Achilles tendon suture.
