What the best suture for Achill tendon repair?

 DISCUSSION/ CONCLUSION: 

The results show that the modified Mason-Allen suture technique maintains a significantly smaller attenuation at the repaired ends under cyclic loading compared with the Krackow suture technique. The attenuation may be explained by both suture pull-out from the tendon repair construct (due to tightening of the loop and/or tearing of tendon fibre) and the amount of tendon and suture incorporated into each repair [4,5]. In this study, the ultimate tensile load in a repair may depend on the suture material and the number of core strands crossing the repair site more so than the suture technique or configuration [6,7]. However, as the number of sutures increases, it is also possible that the suture technique itself becomes the dominating factor since the pullout strength also depends on how well the suture technique holds the soft tissue and minimizes tissue tearing along the fibres at higher load. The suture comparison study shows that Fiberwire suture has a greater inherent tensile strength compared to Ethibond suture while both provide comparable resistance to repair attenuation. In the future, a perspective in vivo randomized controlled trial comparing the different repair techniques with identical accelerated rehabilitation protocols could be performed to demonstrate if a particular repair technique might yield superior clinical outcomes.