Double-Row Achilles Insertional Repair With Rip-Stop Increases Construct Strength Compared to Traditional Techniques:...

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Tendon repair

Background:

• Achilles insertional tendinosis often treated with double-row suture-anchored (DRSA) techniques.
• A common failure mode is suture tearing through the tendon, necessitating improved repair methods.

Purpose of the Study:

• To evaluate a novel rip-stop element integrated into DRSA Achilles repair.
• To determine if the rip-stop technique increases repair strength and reduces failure compared to standard methods.

Main Methods:

• 12 paired cadaveric feet underwent repair: standard double-row (SDR), modified double-row (MDR), or rip-stop double-row (RS-DR).
• Specimens were subjected to cyclic loading and load-to-failure testing.
• Measurements included displacement, stiffness, ultimate load, and failure mode analysis.

Main Results:

• The RS-DR group exhibited significantly lower initial and cyclic displacement compared to SDR and MDR groups.
• RS-DR repairs demonstrated a statistically greater ultimate load than SDR repairs.
• Cyclic stiffness was comparable between RS-DR and MDR groups.

Conclusions:

• The rip-stop technique in DRSA Achilles repair improves biomechanical properties, including reduced displacement and increased ultimate load.
• This rip-stop modification appears more impactful than anchor size alone in enhancing repair integrity.
• The findings suggest potential for mitigating suture tearing and improving clinical outcomes in Achilles tendon repair.