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Title: Different Treatment Approaches for Achilles Tendon Injury-A Comparative Study in Rabbit Model
Authors: محمد مفيد خالد عيد 
Supervisor: د. وليد رينو
Keywords: Achilles Tendon Injury-A Comparative
Issue Date: 2015
Publisher:  Kuwait university - college of graduate studies
Abstract: iv Abstract The Achilles tendon, which serves for insertion of calf muscles (gastrocnemius and soleus) is the strongest tendon in the human body. It is most common tendon susceptible for injury in sports men. Healing of injured tendon is slow and poor because of less vascularity of tendons. Different surgeons use different surgical technique to repair tendon rupture such as open, conservative and closed (percutaneous) techniques for Achilles tendon restoration. However, there is no gold standard method for surgical repair of injured Achilles tendon and efficiency of different techniques are not clearly understood. Therefore, the aim of the present study was to investigate and compare histological and biomechanical features of injured Achilles tendon in the open, conservative and closed (percutaneous) surgical techniques in a rabbit model of Achilles tendon rupture. Three months old, New Zealand white rabbits (3.5 kg, N = 28) were used in the study. A direct injury to the Achilles tendon was introduced (1cm above its insertion) in all rabbits. These tendon injured rabbits were randomly divided into three groups: i) Conservative surgery group (CON), ii) Open surgery group (OP), iii) Closed surgery group (CL). Age matched normal rabbits were used as control group (NC). At the end of the experimental period (Six weeks) animals from the different experimental groups were anesthetised, surgically repaired Achilles tendons were collected for biomechanical and histological study. Surgically repaired tendons were found to be strong and less fibrosed in closed surgery group whereas in open surgery group tendons were strong, but thick due to extensive fibrosis; thin and without fibrosis in conservative group. Histological features of the Achilles tendons showed large amount normal stained collagen fibres in CL group and large amount of abnormally stained collagen fibres in OP group due to intratendinous haemorrhage and inflammatory fluid accumulation. Diameter and cross sectional area of the tendons were significantly more in closed surgery group compared conservative group. Biomechanical strength of the tendons in CL group was highest as revealed by significantly higher extension length and maximum load data compared to control, conservative and open surgery groups. Results of our study showed that the closed (percutaneous) surgical technique is better for surgical repair of injured tendon with greater mechanical strength and better histological features than conservative and open techniques, respectively.
Appears in Programs:0560 Anatomy

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