Double-Row Bridging Suture Fixation Augmented With Double Krackow Suture for the Repair of Avulsion of the Ossified Achilles Tendon

Yamaguchi, Satoshi; Endo, Jun; Yamamoto, Yohei; Sasho, Takahisa

doi:10.1177/1071100715575001

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…In this study, we found that all ruptures occurred at the middle part of the calcific spur, leaving a spur base at the calcaneus. Similar radiological features have been observed in other studies [12][13][14]22]. Because the calcific spur is part of the usually painful problem of Achilles tendinopathy, we removed degenerative tissue together with the main body of the calcified spur and only preserved an approximately 5-mm-flat base at the insertional site as the stump for the bone tunnels.…”

Section: Discussionsupporting

confidence: 68%

Repair of Achilles sleeve avulsion: a new transosseous suture technique

et al. 2020

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Background: Achilles sleeve avulsion usually occurs from pre-existing insertional Achilles tendinopathy, leaving a calcific spur at the insertional site. The purpose of this study was to introduce a new technique using the spur base on the insertional site to drill the suture tunnel to repair Achilles sleeve avulsion. Methods: In total, 11 patients diagnosed with Achilles sleeve avulsion underwent this new surgical technique and were followed for a mean time of 40 months. Clinical outcomes were measured using the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, Victorian Institute of Sports Assessment-Achilles (VISA-A) score, Tegner score, and time taken to return to activities. Preoperative and postoperative MRI, the ability to perform heel rise, and complications were also evaluated. Results: All cases (11/11) had insertional Achilles tendinopathy with calcific spur formation on the tendon's insertion. At final follow-up, the average VAS score improved from 5.3 to 0.1, AOFAS score improved from 44.8 to 97.9, VISA-A score improved from 23.6 to 96.6, and Tegner score improved from 0.9 to 4.9. Tendinopathy symptoms were eliminated. Patients returned to daily activities, work, and sports 3.5 months, 2.8 months, and 12.3months after operation, respectively. Patients took an average of 18.1 weeks after operation to perform the single heel rise test. No severe complications such as infection and rerupture were observed. Conclusion: Our new transosseous suture technique is a promising alternative option in treating Achilles sleeve avulsion. More cases and longer follow up are needed in order to find the best reconstructive option for this pathology.

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Section: Discussionsupporting

confidence: 68%

Repair of Achilles sleeve avulsion: a new transosseous suture technique

et al. 2020

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“…Thus, operative management must rely on tenodesis at the tendon-bone interface. Described repair techniques for distal Achilles tendon ruptures include the use of transcalcaneal drill tunnels, 4,5 suture anchor fixation, 9,15,23,24,31 and a combination of the two. 26 The transcalcaneal tunnel technique has been largely replaced by the popularization of suture anchor fixation, which provides a less invasive option, without the increased risk of calcaneal stress fracture or need for a plantar foot incision associated with the historical transcalcaneal technique.…”

Section: Discussionmentioning

confidence: 99%

Characterization and Surgical Management of Achilles Tendon Sleeve Avulsions

2016

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“…18 Yamaguchi et al reported a small series of 4 cases in which there was avulsion of ossified Achilles tendons from their insertion sites. 19 These injuries were repaired with double row suture anchors as well as an addition of a double Krakow suture augment. In their case series, there were no incidences of repair failure or tendon rupture postoperatively.…”

Section: Discussionmentioning

confidence: 99%

The Addition of a Krackow Rip Stop Suture Augment After Achilles Tendon Debridement for Insertional Achilles Tendinopathy: A Biomechanical Study

Kelsey

Mombell

Fellars

2021

Foot & Ankle Specialist

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Background In the operative treatment of insertional Achilles tendinopathy, the Achilles tendon is often released from its insertion to allow for adequate debridement of pathologic tissue. The use of a double row suture anchor construct has become increasingly favorable among surgeons after Achilles tendon debridement. This study hypothesized that the addition of a Krackow rip stop suture augment to the double row suture anchor construct would increase the repair’s maximum load to failure. A biomechanically stronger repair would potentially decrease the risk of catastrophic failure with early weight-bearing or accidental forced dorsiflexion after operative management for insertional Achilles tendinopathy. Methods Fourteen cadaveric specimens were used to compare the 2 repair techniques. Achilles tendons were debrided and repaired using either a double row suture anchor with and without the additional Krackow rip stop suture augment. The 2 repair techniques were compared using an axial-torsion testing system to measure average load to failure. Results The average load to failure for the double row suture anchor repair alone was 152.00 N. The average load to failure for the tendons with the double row suture anchor with the Krackow rip stop augment was 383.08 N. An independent-samples Mann-Whitney U-test was conducted and the suture anchor plus Krackow augment group had a significantly higher load to failure ( P = .011, Mann-Whitney U = 5.00, n1 = n2 = 7, P < .05, 2-tailed). Conclusion This study confirmed that the addition of a Krakow rip stop augment to the double row suture anchor is able to increase the maximum load to failure when compared to the double row suture anchor alone. These results suggest the potential of this added technique to decrease the risk of catastrophic failure.

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Double-Row Bridging Suture Fixation Augmented With Double Krackow Suture for the Repair of Avulsion of the Ossified Achilles Tendon

Abstract: Level of Evidence:Level V, expert opinion.

Cited by 9 publications

References 17 publications

Repair of Achilles sleeve avulsion: a new transosseous suture technique

Repair of Achilles sleeve avulsion: a new transosseous suture technique

Characterization and Surgical Management of Achilles Tendon Sleeve Avulsions

The Addition of a Krackow Rip Stop Suture Augment After Achilles Tendon Debridement for Insertional Achilles Tendinopathy: A Biomechanical Study

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