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Updated: Jun 28, 2026
A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
Ultrasound-guided Achilles tendon rupture repair using knotless barbed suture: a cadaveric study
Toru Omodani1, Michael Khadavi2,3, Yoshifumi Takatsume4
1Tokyo Advanced Orthopaedics, Tokyo, Japan.
Purpose:
To describe a novel, minimally invasive, ultrasound-guided Achilles tendon repair technique using a knotless barbed suture and to assess its feasibility in a cadaveric model.
Methods:
A midportion Achilles tendon rupture was simulated in a Thiel-embalmed cadaver. The tendon was repaired percutaneously under ultrasound guidance using a 0.6-mm USP 1 knotless barbed suture mounted on a 19-gauge, 3.5-inch curved needle. The needle was advanced intratendinously under continuous ultrasound guidance. Tendon reapproximation was assessed with ultrasound and confirmed by anatomical dissection. The resting plantar flexion angle was measured before and after the repair.
Results:
The Achilles tendon repair technique resulted in successful reapproximation of the tendon ends with anatomic alignment. Post-repair ultrasound and dissection confirmed accurate intratendinous suture placement and full tendon continuity. The resting plantar flexion angle increased from 23° to 50° after the repair.
Conclusion:
This is the first report of an ultrasound-guided Achilles tendon repair using a knotless barbed suture. The technique appears feasible in a cadaveric model and may represent a promising minimally invasive option for patients requiring improved tendon approximation. Its office-based approach may reduce surgical risks associated with conventional repair and tendon elongation seen with conservative treatment. Further biomechanical and clinical studies are warranted to evaluate its safety, durability, and functional outcomes.
