Abstract：
UNASSIGNED: Although double-row suture-anchored (DRSA) techniques for Achilles insertional tendinosis has proven successful, a reoccurring failure mode not yet addressed is suture tearing through the tendon. This study aims to address suture tearing by incorporating a rip-stop element. Authors hypothesized that the Rip-Stop group would demonstrate increased strength compared with more traditional techniques.
UNASSIGNED: 12 paired cadaveric feet were used in this study (n = 24). One sample from each pair was assigned to receive the standard double-row (SDR) Achilles repair with 4.75-mm knotless anchors (n = 12). The control\'s matched sides were divided between 2 DRSA bridge groups: modified double-row (MDR) bridge with 3.9-mm anchors or rip-stop double-row (RS-DR) bridge repair with soft proximal anchors and 3.9-mm anchored distal row. In neutral position, specimens underwent 1000 cycles (20-100 N) followed by load to failure. Displacements, stiffness, ultimate load, and failure mode were recorded.
UNASSIGNED: RS-DR had the lowest initial displacement values followed by SDR and MDR (1.3 ± 0.4, 2.7 ± 1.4, and 3.2 ± 1.3 mm, respectively). Significance was detected when comparing initial displacement of RS-DR to MDR (P = .038). Cyclic displacement was lowest for RS-DR, followed by MDR and SDR (1.6 ± 0.9, 2.2 ± 1.1, and 4.5 ± 3.2 mm, respectively). Cyclic stiffness was similar for RS-DR and MDR (89.1 ± 24.6 and 81.9 ± 5.6 N/mm, respectively). RS-DR ultimate load (1116.8 ± 405.7 N) was statistically greater than SDR (465.6 ± 352.7, P = .003).
UNASSIGNED: RS-DR-repaired specimens demonstrated a decrease in displacement values and increased ultimate load and stiffness when compared to other groups. Results of this cadaveric model suggest that the addition of a rip-stop to DRSA Achilles repair is more impactful than anchor size. Limitations include that this was a time-zero biomechanical study, which cannot simulate the performance of the repairs during postoperative healing and recovery.
UNASSIGNED: A rip-stop technique for Achilles repair effectively improves dynamic mechanical characteristics and may mitigate suture tearing through tendon in a patient cohort.
UNASSIGNED: 12 paired cadaveric feet were used in this study (n = 24). One sample from each pair was assigned to receive the standard double-row (SDR) Achilles repair with 4.75-mm knotless anchors (n = 12). The control\'s matched sides were divided between 2 DRSA bridge groups: modified double-row (MDR) bridge with 3.9-mm anchors or rip-stop double-row (RS-DR) bridge repair with soft proximal anchors and 3.9-mm anchored distal row. In neutral position, specimens underwent 1000 cycles (20-100 N) followed by load to failure. Displacements, stiffness, ultimate load, and failure mode were recorded.
UNASSIGNED: RS-DR had the lowest initial displacement values followed by SDR and MDR (1.3 ± 0.4, 2.7 ± 1.4, and 3.2 ± 1.3 mm, respectively). Significance was detected when comparing initial displacement of RS-DR to MDR (P = .038). Cyclic displacement was lowest for RS-DR, followed by MDR and SDR (1.6 ± 0.9, 2.2 ± 1.1, and 4.5 ± 3.2 mm, respectively). Cyclic stiffness was similar for RS-DR and MDR (89.1 ± 24.6 and 81.9 ± 5.6 N/mm, respectively). RS-DR ultimate load (1116.8 ± 405.7 N) was statistically greater than SDR (465.6 ± 352.7, P = .003).
UNASSIGNED: RS-DR-repaired specimens demonstrated a decrease in displacement values and increased ultimate load and stiffness when compared to other groups. Results of this cadaveric model suggest that the addition of a rip-stop to DRSA Achilles repair is more impactful than anchor size. Limitations include that this was a time-zero biomechanical study, which cannot simulate the performance of the repairs during postoperative healing and recovery.
UNASSIGNED: A rip-stop technique for Achilles repair effectively improves dynamic mechanical characteristics and may mitigate suture tearing through tendon in a patient cohort.
摘要：
■尽管双排缝线锚定（DRSA）技术已被证明是成功的，一种尚未解决的反复出现的失败模式是缝线撕裂肌腱。这项研究旨在通过结合撕裂停止元件来解决缝合线撕裂问题。作者假设，与更传统的技术相比，Rip-Stop小组将表现出更大的力量。
■本研究使用了12只配对的尸体足（n=24）。从每对中分配一个样本，以使用4.75mm无结锚（n=12）进行标准的双排（SDR）跟腱修复。对照组的匹配侧分为2个DRSA桥组：带有3.9mm锚的改良双排（MDR）桥或带有软近端锚和3.9mm的双排（RS-DR）桥修复远端行。在中立位置,标本经历了1000次循环（20-100N），然后负载到失败。位移,刚度,极限载荷,并记录故障模式。
■RS-DR的初始位移值最低，其次是SDR和MDR（1.3±0.4、2.7±1.4和3.2±1.3mm，分别)。当比较RS-DR与MDR的初始位移时检测到显著性(P=.038)。RS-DR的循环位移最低，其次是MDR和SDR（1.6±0.9，2.2±1.1和4.5±3.2mm，分别)。RS-DR和MDR的循环刚度相似（89.1±24.6和81.9±5.6N/mm，分别)。RS-DR极限载荷(1116.8±405.7N)大于SDR(465.6±352.7,P=.003)。
■与其他组相比，RS-DR修复的标本显示出位移值降低，极限载荷和刚度增加。此尸体模型的结果表明，在DRSA跟腱修复中添加切块比锚大小更有影响力。局限性包括这是一项零时生物力学研究，这不能模拟术后愈合和恢复期间的修复性能。
■跟腱修复的止裂技术可有效改善动态力学特性，并可减轻患者队列中通过肌腱的缝线撕裂。
■本研究使用了12只配对的尸体足（n=24）。从每对中分配一个样本，以使用4.75mm无结锚（n=12）进行标准的双排（SDR）跟腱修复。对照组的匹配侧分为2个DRSA桥组：带有3.9mm锚的改良双排（MDR）桥或带有软近端锚和3.9mm的双排（RS-DR）桥修复远端行。在中立位置,标本经历了1000次循环（20-100N），然后负载到失败。位移,刚度,极限载荷,并记录故障模式。
■RS-DR的初始位移值最低，其次是SDR和MDR（1.3±0.4、2.7±1.4和3.2±1.3mm，分别)。当比较RS-DR与MDR的初始位移时检测到显著性(P=.038)。RS-DR的循环位移最低，其次是MDR和SDR（1.6±0.9，2.2±1.1和4.5±3.2mm，分别)。RS-DR和MDR的循环刚度相似（89.1±24.6和81.9±5.6N/mm，分别)。RS-DR极限载荷(1116.8±405.7N)大于SDR(465.6±352.7,P=.003)。
■与其他组相比，RS-DR修复的标本显示出位移值降低，极限载荷和刚度增加。此尸体模型的结果表明，在DRSA跟腱修复中添加切块比锚大小更有影响力。局限性包括这是一项零时生物力学研究，这不能模拟术后愈合和恢复期间的修复性能。
■跟腱修复的止裂技术可有效改善动态力学特性，并可减轻患者队列中通过肌腱的缝线撕裂。
