The literature regarding the management of spontaneous rupture of the Achilles tendon is controversial and confusing. The relative infrequency of the condition in any one center prohibits the completion of well-designed clinical studies. Many of the disputes could be addressed and innovations tested if an appropriate animal model were available. We present a method for evaluating Achilles tendon function from measurements of the prints, preserved in bromphenol-blue-impregnated photocopying paper, of the hindfeet of walking rats. The stimulus for this study was derived from de Medinaceli's method for assessing the functional condition of rat sciatic nerves (de Medinaceli L, Freed WJ, Wyatt RJ: An index of the functional condition of rat sciatic nerve based on measurements made from walking tracks. Exp Neurol 77:634-643, 1982). Four variables were measured from these walking tracks, and comparisons between the damaged (experimental) and intact (normal) side were converted to proportional deficits. The relative contribution of each parameter to the overall deficit was determined by multiple linear regression analysis, and the variables were weighted accordingly to obtain an "Achilles Functional Index" (AFI). A sham operation produced no functional deficit, whereas animals subjected to a 0.5-cm midsubstance Achilles tendon defect demonstrated a markedly impaired AFI. Animals with repaired transected Achilles tendons also demonstrated a significant, but less severely impaired AFI. The functional deficit in this repair group returned to control values by postoperative day 15, whereas animals with a defect remained impaired at day 15. Furthermore, an excellent correlation was found between the functional recovery and biomechanical properties (ultimate failure load) of the healing tendon (r = 0.94; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of this study was to evaluate the effects of immobilization and mobilization on the functional and biomechanical recovery of injured Achilles tendons. Male Sprague-Dawley rats were allocated randomly into four groups: (a) sham operation, (b) division only (surgical transection of the Achilles tendon without immobilization), (c) "dummy" external fixation (division of the Achilles tendon and application of Kirschner wires), and (d) rigid external fixation (division of the Achilles tendon and immobilization with Kirschner wires connected by two triangular frames). All procedures were performed on the right lower limb; the left, uninjured, lower limb served as an internal control. Kirschner wires and external fixators were removed on day 12. Functional performance was determined from measurements of hind pawprints of rats walking preoperatively and on postoperative days 1, 3, 5, 7, 9, 11, 13, and 15. On day 15, the animals were killed and biomechanical evaluations were performed on both the injured and the uninjured Achilles tendon constructs. No functional or mechanical deficits were observed in the sham-operation group. Animals subjected to division of the Achilles tendon had an initial functional deficit that returned to near normal by day 15. The application of Kirschner wires was associated with an impairment of the functional performance of the rat as well as of the mechanical properties of the tendon-bone constructs. Immobilization by connection of the Kirschner wires to an external frame had an additional, highly significant (p < 0.001) detrimental effect on the functional and mechanical recovery of Achilles tendon-calcaneal complexes.
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