Achilles tendon rupture repair: Biomechanical comparison of the triple bundle technique versus the Krakow locking loop technique

This study was designed to compare the tensile strength of ruptured Achille s tendons repaired using either the triple bundle technique or the Krakow l ocking loop technique. Eight pairs of fresh frozen cadaveric Achilles tendo ns were harvested. A simulated "Achilles tendon rupture" was created 4 cm f rom the calcaneal insertion in all sixteen tendons by transversely cutting the tendon with a scalpel. One Achilles tendon "rupture" of a pair was repa ired using the triple bundle technique, while the other tendon of the pair was repaired using the Krakow locking loop technique. Then, using a servohy draulic testing machine, each tendon was tested to failure in tension at a displacement rate of 2.54 cm/sec. The average rupture load for the triple b undle technique was 453 N (range 397 (n) over tilde 549 N), while the avera ge rupture load for the Krakow locking loop technique was 161 N (range 121 (n) over tilde 216 N). This difference in averages represents a statistical ly significant superiority of 2.8 to 1 (p < 0.001) in favor of the triple b undle technique.