Clinical Comparison of the Two-Stranded Single Krackow and Four-Stranded Double Krackow Techniques for Acute Achilles Tendon Ruptures

Abstract

Category: Sports Introduction/Purpose: Introduction: Several different configurations of the Krackow stitch have been used for acute achilles tendon rupture repair. Despite there are a few biomechanical studies comparing different Krackow stitch configurations, we could find no studies that have compared the clinical outcome of these different suture methods. This study aims to compare the clinical outcomes and complications of the two-stranded single Krackow and four-stranded double Krackow techniques. Methods: Materials and methods: We retrospectively reviewed 48 consecutive patients who underwent an open repair using the two-stranded single Krackow (17 pateints) or four-stranded double Krackow techniques (31 patients) between September 2011 and August 2014. Isokinetic strength of plantar-flexion and dorsiflexion of both ankles was assessed on a Cybex dynamometer at 6 months after surgery. Clinical outcomes were evaluated at 12 months postoperativly. Results: Results: There were no significant differences between groups with regard to patient demographics or activity levels prior to treatment. At the time of follow-up at one year, there were no significant differences in the American Orthopaedic Foot and Ankle Society ankle–hindfoot score and four-point Boyden scale. One case of rerupture and one case of superficial wound dehiscence occurred in the double Krackow group, but there was no complication in the single Krackow group. The mean peak torque deficits and work deficits in both plantar flexion and dorsiflexion showed no differences between the groups with any angular velocity. Conclusion: Conclusion: The two-stranded single Krackow and four-stranded double Krackow techniques for acute achilles tendon ruptures resulted in similar clinical outcomes and isokinetic strengths. The overall complication rates were low in both suture techniques.