Biochemistry and biomechanics of healing tendon: Part I. effects of rigid plaster casts and functional casts

STEHNO-BITTEL, LISA; REDDY, G. KESAVA; GUM, STEVEN; ENWEMEKA, CHUKUKA S.

Medicine & Science in Sports & Exercise: June 1998 - Volume 30 - Issue 6 - pp 788-793
Clinical Sciences: Clinical Investigations

Biochemistry and biomechanics of healing tendon: Part I. effects of rigid plaster casts and functional casts. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 788-793, 1998.

Purpose: Traditional treatment of surgically repaired Achilles tendons includes complete immobilization of the joint in rigid casts for 6 to 8 wk. We tested the use of functional polyurethane casts as an alternative to rigid plaster casts after experimental tenotomy and repair of the rabbit Achilles tendon.

Methods: After repair the limbs of 15 experimental rabbits were immobilized in a functional polyurethane cast for 15 d, while those of 14 controls were immobilized in traditional rigid plaster casts for the same period.

Results: Functional casting resulted in a 60% increase in total collagen in the neotendon compared with that in rigid casting (P < 0.05). Mature collagen cross-links declined 8% in the tendons with functional casts. The biomechanical parameters of the tendons changed with functional casting, showing a 20% increase in maximum load and 21% increase in maximum stress.

Conclusions: These changes were noted without any cases of tendon re-rupture in either type of cast. Thus, functional casting following surgery of Achilles tendons appears to improve healing without significant risks of re-rupture.

Department of Physical Therapy Education, University of Kansas Medical Center, Kansas City, KS 66160-7601

Submitted for publication January 1997.

Accepted for publication November 1997.

This work was supported by the Department of Veteran Affairs, Rehabilitation, Research, and Development Program, NIDRR (H133G20220) and NIH-NICHD.

Address for correspondence: Dr. Chukuka S. Enwemeka, Department of Physical Therapy Education, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160-7601. E-mail: enwemeka@kumc.edu.

© Williams & Wilkins 1998. All Rights Reserved.