DOI QR코드

DOI QR Code

Comparison of Augmentation Method for Achilles Tendon Repair: Using Thoracolumbar Fascia and the Polypropylene Mesh

  • Jieun Seo (Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University) ;
  • Won-Jae Lee (Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University) ;
  • Min Jang (Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University) ;
  • Min-Soo Seo (Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University) ;
  • Seong Mok Jeong (Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University) ;
  • Sae-Kwang Ku (Department of Anatomy and Histology, College of Korean Medicine, Daegu Haany University) ;
  • Youngsam Kwon (Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University) ;
  • Sungho Yun (Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University)
  • Received : 2022.10.27
  • Accepted : 2023.01.16
  • Published : 2023.02.28

Abstract

This study aimed to compare complete ruptured tendon healing between two different repair methods using the Achilles tendon of New Zealand white rabbits. Thoracolumbar fascia (TF) padded Kessler suture, polypropylene mesh (PM) padded Kessler suture, and Kessler suture only were performed on the completely transected lateral gastrocnemius tendon, and biomechanical and histologic characteristics were assessed after 8 weeks. For biomechanical assessment, the tensile strength of each repaired tendon was measured according to the established methods. For histomorphometric analysis, hematoxylin and eosin staining for general histology, and Masson's trichrome (MT) staining for collagen fibers, Alcian blue (AB) staining for proteoglycans were performed and analyzed. Significant increases in tensile strength with remarkable decreases in the abnormalities against nuclear roundness, cell density, fiber structure, and fiber alignment and significant decreases in the mean number of infiltrated inflammatory cells and AB-positive proteoglycan-occupied regions with increases in MT-positive collagen fiber-occupied regions were demonstrated in the Kessler suture with PM or TF padding groups as compared to those of the Kessler suture group. Both of PM and TF provided potent tensile strength and supported healing with the evidence of histological examinations. This means that augmentation with PM is useful for repairing a completely ruptured Achilles tendon, without additional surgery for autograft material harvesting.

Keywords

References

  1. Asai K, Suzuki K, Shimota H, Ito Y, Asano K, Kazui T. Full-thickness chest wall reconstruction using autologous tissue grafts after resection of recurrent desmoid tumor. Jpn J Thorac Cardiovasc Surg 2004; 52: 296-299. https://doi.org/10.1007/s11748-004-0046-7
  2. Audenaert E, Van Nuffel J, Schepens A, Verhelst M, Verdonk R. Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 2006; 14: 360-364. https://doi.org/10.1007/s00167-005-0689-7
  3. Baltzer WI, Rist P. Achilles tendon repair in dogs using the semitendinosus muscle: surgical technique and short-term outcome in five dogs. Vet Surg 2009; 38: 770-779. https://doi.org/10.1111/j.1532-950X.2009.00565.x
  4. Bongartz A, Carofiglio F, Balligand M, Heimann M, Hamaide A. Use of autogenous fascia lata graft for perineal herniorrhaphy in dogs. Vet Surg 2005; 34: 405-413. https://doi.org/10.1111/j.1532-950X.2005.00062.x
  5. Bottagisio M, Lovati AB. A review on animal models and treatments for the reconstruction of Achilles and flexor tendons. J Mater Sci Mater Med 2017; 28: 45.
  6. Braden T. Fascia lata transplant for repair of chronic Achilles tendon defects. J Am Anim Hosp Assoc 1976; 12: 800-805.
  7. Chen J, Yu Q, Wu B, Lin Z, Pavlos NJ, Xu J, et al. Autologous tenocyte therapy for experimental Achilles tendinopathy in a rabbit model. Tissue Eng Part A 2011; 17: 2037-2048. https://doi.org/10.1089/ten.tea.2010.0492
  8. Corr SA, Draffan D, Kulendra E, Carmichael S, Brodbelt D. Retrospective study of Achilles mechanism disruption in 45 dogs. Vet Rec 2010; 167: 407-411. https://doi.org/10.1136/vr.c4190
  9. Dal-Bo IdS, Ferrigno CRA, Macedo AS, Paes F, dos Santos JF, Marinho PVT, et al. Tenorrhaphy of the common calcaneal tendon in dogs and cats. Acta Sci Vet 2016; 44(Suppl 1): 144.
  10. de Battisti A, Polton G, de Vries M, Friend E. Chest wall reconstruction with latissimus dorsi and an autologous thoracolumbar fascia graft in a dog. J Small Anim Pract 2015; 56: 218-222. https://doi.org/10.1111/jsap.12270
  11. El-Taliawi OG, Taguchi T, Dong F, Battig J, Griffon DJ. Biocompatibility of allogenic canine fascia lata: in vitro evaluation and small case series. Vet Surg 2020; 49: 310-320. https://doi.org/10.1111/vsu.13358
  12. Farkas LG, McCain WG, Sweeney P, Wilson W, Hurst LN, Lindsay WK. An experimental study of the changes following silastic rod preparation of a new tendon sheath and subsequent tendon grafting. J Bone Joint Surg Am 1973; 55: 1149-1158. https://doi.org/10.2106/00004623-197355060-00002
  13. Fridman R, Rahimi F, Lucas P, Daugherty R, Hoffmann H. Repair of nelgected Achilles tendon rupture with monofilament polypropylene mesh: a case study of 12 patients. Foot Ankle J 2008; 1: 2.
  14. Gabler C, Sass JO, Gierschner S, Lindner T, Bader R, Tischer T. In vivo evaluation of different collagen scaffolds in an Achilles tendon defect model. Biomed Res Int 2018; 2018: 6432742.
  15. Gall TT, Santoni BG, Egger EL, Puttlitz CM, Rooney MB. In vitro biomechanical comparison of polypropylene mesh, modified three-loop pulley suture pattern, and a combination for repair of distal canine Achilles' tendon injuries. Vet Surg 2009; 38: 845-851. https://doi.org/10.1111/j.1532-950X.2009.00598.x
  16. Gelberman RH, Boyer MI, Brodt MD, Winters SC, Silva MJ. The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs. J Bone Joint Surg Am 1999; 81: 975-982. https://doi.org/10.2106/00004623-199907000-00010
  17. Henderson ER, Friend EJ, Toscano MJ, Parsons KJ, Tarlton JF. Biomechanical comparison of canine fascia lata and thoracolumbar fascia: an in vitro evaluation of replacement tissues for body wall reconstruction. Vet Surg 2015; 44: 126-134. https://doi.org/10.1111/j.1532-950X.2014.12247.x
  18. Ho TC, Tsai SH, Yeh SI, Chen SL, Tung KY, Chien HY, et al. PEDF-derived peptide promotes tendon regeneration through its mitogenic effect on tendon stem/progenitor cells. Stem Cell Res Ther 2019; 10: 2.
  19. Hohendorff B, Siepen W, Staub L. Treatment of acute Achilles tendon rupture: fibrin glue versus fibrin glue augmented with the plantaris longus tendon. J Foot Ankle Surg 2009; 48: 439-446. https://doi.org/10.1053/j.jfas.2009.04.005
  20. Hooley C, Cohen R. A model for the creep behaviour of tendon. Int J Biol Macromol 1979; 1: 123-132. https://doi.org/10.1016/0141-8130(79)90028-X
  21. Kearney RS, Costa ML. Current concepts in the rehabilitation of an acute rupture of the tendo Achillis. J Bone Joint Surg Br 2012; 94: 28-31. https://doi.org/10.1302/0301-620X.94B1.28008
  22. Lister SA, Renberg WC, Roush JK. Efficacy of immobilization of the tarsal joint to alleviate strain on the common calcaneal tendon in dogs. Am J Vet Res 2009; 70: 134-140. https://doi.org/10.2460/ajvr.70.1.134
  23. Maffulli N, Leadbetter WB. Free gracilis tendon graft in neglected tears of the Achilles tendon. Clin J Sport Med 2005; 15: 56-61. https://doi.org/10.1097/01.jsm.0000152714.05097.ef
  24. McCartney W, Ober C, Benito M, MacDonald B. Suturing Achilles tendon and mesh simultaneously in augmented repair resists gap formation foremost: an experimental study. J Orthop Surg Res 2019; 14: 332.
  25. Nicholls F, Bauerle V, Buschmann J. Casting hind legs of rabbits after full transection of Achilles tendons-impact of cast's color and composition. J Vet Clin Pract Pet Care 2016; 2: 101.
  26. Oakes BW. Tissue healing and repair: tendons and ligaments. In: Frontera WR, editor. Rehabilitation of sports injuries: scientific basis. Hoboken: John Wiley & Sons. 2003:28-98.
  27. Orishimo KF, Burstein G, Mullaney MJ, Kremenic IJ, Nesse M, McHugh MP, et al. Effect of knee flexion angle on Achilles tendon force and ankle joint plantarflexion moment during passive dorsiflexion. J Foot Ankle Surg 2008; 47: 34-39. https://doi.org/10.1053/j.jfas.2007.10.008
  28. Prodromos CC, Fu FH, Howell SM, Johnson DH, Lawhorn K. Controversies in soft-tissue anterior cruciate ligament reconstruction: grafts, bundles, tunnels, fixation, and harvest. J Am Acad Orthop Surg 2008; 16: 376-384. https://doi.org/10.5435/00124635-200807000-00003
  29. Schneppendahl J, Thelen S, Schek A, Bala I, Hakimi M, Grassmann JP, et al. Initial stability of two different adhesives compared to suture repair for acute Achilles tendon rupture--a biomechanical evaluation. Int Orthop 2012; 36: 627-632. https://doi.org/10.1007/s00264-011-1357-9
  30. Sebastian H, Datta B, Maffulli N, Neil M, Walsh WR. Mechanical properties of reconstructed Achilles tendon with transfer of peroneus brevis or flexor hallucis longus tendon. J Foot Ankle Surg 2007; 46: 424-428. https://doi.org/10.1053/j.jfas.2007.07.003
  31. Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am 2005; 87: 187-202.
  32. Sivacolundhu R, Marchevsky A, Read R, Eger C. Achilles mechanism reconstruction in four dogs Murdoch University Veterinary Hospital, Murdoch, WA, Australia. Vet Comp Orthop Traumatol 2001; 14: 25-31. https://doi.org/10.1055/s-0038-1632669
  33. Skalec A, Janeczek M, Czerski A. Anatomy and histology of the rabbit common calcanean tendon. Anat Histol Embryol 2019; 48: 466-475. https://doi.org/10.1111/ahe.12468
  34. Tempfer H, Kaser-Eichberger A, Lehner C, Gehwolf R, Korntner S, Kunkel N, et al. Bevacizumab improves Achilles tendon repair in a rat model. Cell Physiol Biochem 2018; 46: 1148-1158. https://doi.org/10.1159/000489057
  35. Wu F, Nerlich M, Docheva D. Tendon injuries: basic science and new repair proposals. EFORT Open Rev 2017; 2: 332-342. https://doi.org/10.1302/2058-5241.2.160075
  36. Yang S, Shi X, Li X, Wang J, Wang Y, Luo Y. Oriented collagen fiber membranes formed through counter-rotating extrusion and their application in tendon regeneration. Biomaterials 2019; 207: 61-75. https://doi.org/10.1016/j.biomaterials.2019.03.041