Comparison of unrepaired, primarily repaired, and polyglactin mesh-reinforced Achilles tendon lacerations in rabbits

The tensile and histologic characteristics of sharply transected Achilles tendons treated by cast immobilization, surgical repair, and surgical repair reinforced with polyglactin mesh were evaluated in 31 rabbits. All modes of tendon treatment resulted in tensile failure at significantly lower loads than in the contralateral control tendons. However, when the cross-sectional area and rupture stress of each pair of tendons were considered, the surgically repaired tendons more closely approximated the load tolerance of the control side than did the unrepaired, casted tendons. The mesh-reinforced tendons exhibited no mechanical superiority to the suture-repaired tendons. No microscopic difference in the quality of collagen deposition for the three types of repairs was apparent. Subcutaneous mesh did not evoke a significant cellular or fibrous reaction and was totally absorbed by the time of necropsy. A significant difference was found between the tolerated stress of the unrepaired and repaired tendons, but no functional benefit of repairing acutely transected Achilles tendons with synthetic mesh was observed.