Our Summary

This research paper looks at how to better repair tendon injuries, which are becoming more common due to an aging population and higher physical activity demands. The study uses a rat model to examine the best way to repair a specific type of tendon injury (Achilles tendon).

Three different stitching techniques were tested on rat cadavers, with a focus on how much weight each technique could withstand before failing. The Achilles tendon was intentionally damaged and then repaired using a collagen scaffold (a kind of biological ‘glue’) and one of the three stitching methods.

The results showed that the simplest stitching method was the weakest, failing under a weight of around 6.6 Newtons (N). The other two methods, which used more complex stitches, were able to withstand more than double this weight (over 14 N) before failing.

The study concludes that these more complex stitches should be preferred for this kind of repair, as they can handle more weight and therefore may reduce the risk of the tendon re-tearing. The stitching material and the collagen scaffold remained mostly intact in all scenarios, indicating that the failure was due to the tendon tissue itself.

FAQs

  1. What was the main focus of the tendon repair research study?
  2. What were the results of the study in terms of the weight each stitching method could withstand before failing?
  3. Based on the study, what is the recommended method for repairing Achilles tendon injuries?

Doctor’s Tip

Based on this research, a doctor might advise a patient undergoing tendon repair to discuss with their surgeon the use of more complex stitching techniques to ensure a stronger and more durable repair. The patient should also follow their post-operative rehabilitation plan carefully to promote proper healing and prevent re-injury. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support overall tendon health and prevent future injuries.

Suitable For

Patients who may benefit from tendon repair surgery include those who have suffered from a traumatic injury, such as a sports injury or a fall, which has resulted in a tendon tear or rupture. Tendon repair may also be recommended for individuals with chronic tendon conditions, such as tendinosis or tendinitis, that have not responded to conservative treatments like rest, physical therapy, and anti-inflammatory medications.

Additionally, individuals with underlying medical conditions that affect tendon health, such as rheumatoid arthritis or diabetes, may be at a higher risk for tendon injuries and may require surgical intervention to repair damaged tendons.

Ultimately, the decision to recommend tendon repair surgery will depend on the severity of the injury, the individual’s overall health and activity level, and the expected outcome of the surgery. It is important for patients to work closely with their healthcare provider to determine the most appropriate treatment plan for their specific situation.

Timeline

Timeline of patient experience before and after tendon repair:

Before tendon repair:

  1. Patient experiences a tendon injury, such as a tear or rupture, often due to physical activity or trauma.
  2. Patient may experience pain, swelling, and limited range of motion in the affected area.
  3. Patient undergoes medical evaluation and imaging tests, such as MRI, to determine the extent of the tendon injury.
  4. Treatment options are discussed with the patient, including conservative measures like rest, physical therapy, and pain management, as well as surgical repair for severe cases.
  5. If surgery is recommended, the patient undergoes pre-operative preparation, including medical clearance and instructions for fasting before the procedure.

After tendon repair:

  1. Patient undergoes tendon repair surgery, which may involve using a collagen scaffold or other biological materials to assist in the healing process.
  2. Patient is monitored in the recovery room for any immediate post-operative complications.
  3. Patient begins physical therapy and rehabilitation to restore strength and function in the repaired tendon.
  4. Patient may experience pain, swelling, and stiffness in the early stages of recovery, which can be managed with medications and ice therapy.
  5. Over time, the patient gradually regains range of motion and strength in the repaired tendon through continued physical therapy and exercises.
  6. Follow-up appointments with the surgeon are scheduled to monitor the healing progress and address any concerns or complications.
  7. Patient is advised to gradually return to normal activities and sports, following a personalized rehabilitation plan to prevent re-injury.
  8. With proper care and adherence to post-operative instructions, the patient can expect to make a full recovery and regain functional use of the repaired tendon.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tendon repair based on this research include:

  1. What type of stitching technique will be used to repair my tendon injury?
  2. How does the strength of the stitching technique used in my tendon repair compare to other methods?
  3. Will a collagen scaffold be used in my tendon repair, and if so, how does it help with the healing process?
  4. What weight or load can my repaired tendon withstand after surgery?
  5. How long is the recovery process expected to be after tendon repair surgery using the chosen stitching technique?
  6. Are there any specific post-operative exercises or precautions I should take to prevent re-injury of the tendon?
  7. Are there any potential complications or risks associated with the chosen stitching technique for tendon repair?
  8. How successful have previous patients been with this particular stitching technique for tendon repair?
  9. What is the expected outcome in terms of function and mobility after tendon repair using this stitching technique?
  10. Are there any alternative treatments or surgical approaches that could be considered for my tendon injury?

Reference

Authors: Gabler C, Gierschner S, Tischer T, Bader R. Journal: Acta Bioeng Biomech. 2018;20(2):73-77. PMID: 30220720