Abstract：
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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
背景：在插入式跟腱病的手术治疗中，跟腱通常从其插入中释放，以允许对病理组织进行充分的清创。在跟腱清创术后，双排缝合锚钉结构的使用在外科医生中变得越来越有利。这项研究假设，在双排缝线锚钉结构中添加Krackow裂口缝合增强剂将增加修复失败的最大负荷。生物力学更强的修复可能会降低手术治疗后早期负重或意外强迫背屈的灾难性失败的风险。
方法：用14例尸体标本比较两种修复技术。使用双排缝合锚钉对跟腱进行清创和修复，并带有和不带有额外的Krackow裂口缝合补片。使用轴向扭转测试系统比较了两种修复技术，以测量平均失效载荷。
结果：仅双排缝合锚钉修复的平均失败负荷为152.00N。使用双排缝合锚钉并增加Krackow裂口的肌腱的平均失败负荷为383.08N。进行了独立样本Mann-WhitneyU检验，缝合锚钉加Krackowaugment组的失败负荷明显更高（P=.0U=2，Mannney=2）
结论：这项研究证实，与单独使用双排缝线锚相比，在双排缝线锚钉中添加克拉科夫裂口补片能够增加最大失效负荷。这些结果表明，这种附加技术具有降低灾难性故障风险的潜力。
方法：用14例尸体标本比较两种修复技术。使用双排缝合锚钉对跟腱进行清创和修复，并带有和不带有额外的Krackow裂口缝合补片。使用轴向扭转测试系统比较了两种修复技术，以测量平均失效载荷。
结果：仅双排缝合锚钉修复的平均失败负荷为152.00N。使用双排缝合锚钉并增加Krackow裂口的肌腱的平均失败负荷为383.08N。进行了独立样本Mann-WhitneyU检验，缝合锚钉加Krackowaugment组的失败负荷明显更高（P=.0U=2，Mannney=2）
结论：这项研究证实，与单独使用双排缝线锚相比，在双排缝线锚钉中添加克拉科夫裂口补片能够增加最大失效负荷。这些结果表明，这种附加技术具有降低灾难性故障风险的潜力。
