¿Es la técnica Dresden un diseño mecánico de elección apropiado para la reparación de roturas de tercio medio del tendón de Aquiles? Ensayo biomecánico / Is the Dresden technique a mechanical design of choice suitable for the repair of middle third Achilles tendon ruptures? A biomechanical study

Objetivo. Comparar el fallo mecánico de la técnica Dresden para la reparación del tendón de Aquiles respecto a la técnica de reparación control Kessler doble modificada. Secundariamente, comparar la resistencia máxima de la técnica de reparación Dresden respecto a la técnica de reparación control Kessler doble modificada. Material y métodos. Un total de 30 roturas de tendón de Aquiles en especímenes bovinos fueron reparadas con sutura Ethibond® a 4,5cm desde la inserción calcánea. Cada rotura fue distribuida de modo aleatorio en uno de 2 grupos quirúrgicos. Una vez reparadas, cada espécimen se sometió a una prueba de tracción máxima. Mediante una prueba exacta de Fisher (α=0,05) se compararon las tasas (proporciones) de fallo mecánico (tendón, sutura o nudo), y mediante una prueba t de Student (α=0,05), las resistencias máximas. Resultados. Las proporciones de fallo mecánico entre las reparaciones fueron diferentes, siendo el fallo mecánico más frecuente el desgarro del tendón en la técnica Dresden y la rotura de la sutura en la técnica Kessler. La reparación Dresden desarrolló 245,4N y la reparación Kessler desarrolló 154,6N. Discusión. La reparación con técnica Dresden realizada de modo abierto respecto a la técnica Kessler posee un diseño mecánico más apropiado para la reparación de roturas de tercio medio del tendón de Aquiles al desarrollar mayor resistencia tensil en un 58,7%. No obstante, su fallo mecánico más frecuente fue el desagarro tendinoso, que frente a cargas inapropiadas puede favorecer el alargamiento del tendón de Aquiles (AU)

Objective. To compare the mechanical failure of the Dresden technique for Achilles tendon repair with the double modified Kessler technique controlled repair technique. The maximum resistance of the two repair techniques are also compared. Material and methods. A total of 30 Achilles tendon ruptures in bovine specimens were repaired with an Ethibond® suture to 4.5cm from the calcaneal insertion. Each rupture was randomly distributed into one of two surgical groups. After repair, each specimen was subjected to a maximum traction test. The mechanical failure (tendon, suture, or knot) rates (proportions) were compared using the exact Fisher test (α=.05), and the maximum resistances using the Student t test (α=.05). Results. There was a difference in the proportions of mechanical failures, with the most frequent being a tendon tear in the Dresden technique, and a rupture of the suture in the Kessler technique. Discussion. The repair using the Dresden technique performed in the open mode, compared to the Kessler technique, has a more suitable mechanical design for the repair of middle third Achilles tendon ruptures on developing a higher tensile resistance in 58.7%. However, its most common mechanical failure was a tendon tear, which due to inappropriate loads could lead to lengthening of the Achilles tendon (AU)

Is the Dresden technique a mechanical design of choice suitable for the repair of middle third Achilles tendon ruptures? A biomechanical study. / ¿Es la técnica Dresden un diseño mecánico de elección apropiado para la reparación de roturas de tercio medio del tendón de Aquiles? Ensayo biomecánico.

OBJECTIVE: To compare the mechanical failure of the Dresden technique for Achilles tendon repair with the double modified Kessler technique controlled repair technique. The maximum resistance of the two repair techniques are also compared. MATERIAL AND METHODS: A total of 30 Achilles tendon ruptures in bovine specimens were repaired with an Ethibond(®) suture to 4.5cm from the calcaneal insertion. Each rupture was randomly distributed into one of two surgical groups. After repair, each specimen was subjected to a maximum traction test. The mechanical failure (tendon, suture, or knot) rates (proportions) were compared using the exact Fisher test (α=.05), and the maximum resistances using the Student t test (α=.05). RESULTS: There was a difference in the proportions of mechanical failures, with the most frequent being a tendon tear in the Dresden technique, and a rupture of the suture in the Kessler technique. DISCUSSION: The repair using the Dresden technique performed in the open mode, compared to the Kessler technique, has a more suitable mechanical design for the repair of middle third Achilles tendon ruptures on developing a higher tensile resistance in 58.7%. However, its most common mechanical failure was a tendon tear, which due to inappropriate loads could lead to lengthening of the Achilles tendon.