Endto End Suture versus Tendon Augmentation

Augmenting an Achilles tendon repair aims to provide a stronger repair and decrease the chance of re-rupture. However, comparisons between simple end-to-end sutures and augmentation for the management of acute uncomplicated ruptures have detected no clinically significant differences.52-54 Thus, a nonaugmented end-to-end repair is the management of choice.55 The strength of the repair will differ according the suture techniques,56-59 although this does not always predict a better outcome.60 Mortensen et al.60 compared in a randomized trial a weaker Mason suture technique with a stronger reinforced continuous six-strand suture technique in end-to-end repair. No difference was found between the two techniques, suggesting no advantage for more complicated suture techniques.60

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