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Related Experiment Video

Updated: May 20, 2026

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

Published on: January 13, 2026

Fixation of the Achilles tendon insertion using suture button technology.

Nathan J Fanter¹, Edward W Davis, Champ L Baker

¹Hughston Clinic, 6262 Veterans Parkway, PO Box 9517, Columbus, GA 31908-9517, USA.

The American Journal of Sports Medicine

|July 18, 2012

Summary

This study found transcalcaneal drill pin passage safe for Achilles tendon repair. Adding a Krackow stitch and suture button significantly increases repair strength, potentially improving patient outcomes.

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Area of Science:

Orthopedic Surgery
Biomechanical Engineering
Anatomy

Background:

Operative treatment for Achilles insertional tendinopathy lacks standardized fixation guidelines.
Evaluating superior fixation methods is crucial for improving surgical outcomes.

Purpose of the Study:

To assess the anatomical safety of transcalcaneal drill pin passage.
To compare the biomechanical strength of Achilles tendon insertional repairs using different fixation techniques.

Main Methods:

A controlled laboratory study using 6 fresh-frozen cadaveric ankles.
Transcalcaneal drill pins were passed, and anatomical structures were dissected.
Achilles tendons were repaired with suture anchors alone or with added Krackow stitch and suture button.

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Last Updated: May 20, 2026

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

Published on: January 13, 2026

Repairs were tested to failure to determine ultimate load capacity.

Main Results:

Transcalcaneal drill pin passage was found to be anatomically safe.
Repairs augmented with a Krackow stitch and suture button demonstrated significantly higher ultimate load to failure (391.4 N) compared to suture anchors alone (239.2 N).
The lateral plantar artery was the closest structure to the drill pin, with a mean distance of 22.7 mm.

Conclusions:

Transcalcaneal drill pin passage is anatomically safe for Achilles tendon insertional repair.
The addition of a Krackow stitch and suture button significantly enhances the strength of Achilles tendon insertional repairs.
This stronger fixation may allow for earlier postoperative rehabilitation and improved clinical results.