Biologic Adjuncts for Surgical Repair
We cannot recommend for or against the use of allograft, autograft, xenograft, synthetic tissue, or biologic adjuncts in all acute Achilles tendon ruptures that are treated operatively.
Rationale
A systematic review failed to identify adequate evidence to make a recommendation for or against the use of allograft, autograft, xenograft, synthetic tissue, or biologic adjuncts in acute Achilles tendon ruptures that are treated operatively.
No studies addressed adjunctive augmentation with allograft, xenograft, or biologic adjuncts.
Three level II studies32, 37, 38 compared open repair alone and autograft augmentation. One level IV study39 compared patients treated with synthetic tissue augmentation to open repair alone. All four of these studies failed to demonstrate significant improvement in outcomes or complications.
No studies addressed adjunctive augmentation with allograft, xenograft, or biologic adjuncts.
Three level II studies32, 37, 38 compared open repair alone and autograft augmentation. One level IV study39 compared patients treated with synthetic tissue augmentation to open repair alone. All four of these studies failed to demonstrate significant improvement in outcomes or complications.
- (32) Aktas S, Kocaoglu B, Nalbantoglu U, Seyhan M, Guven O. End-to-end versus augmented repair in the treatment of acute Achilles tendon ruptures. J Foot Ankle Surg 2007;46(5):336-340.
- (37) Pajala A, Kangas J, Siira P, Ohtonen P, Leppilahti J. Augmented compared with nonaugmented surgical repair of a fresh total Achilles tendon rupture. A prospective randomized study. J Bone Joint Surg Am 2009;91(5):1092-1100.
- (38) Taglialavoro G, Stecco C. The subcutaneous Achilles tendon rupture: Comparison of three surgical techniques. Foot and Ankle Surgery 2004;10(4):187-194.
- (39) Giannini S, Girolami M, Ceccarelli F, Catani F, Stea S. Surgical repair of achilles tendon ruptures using polypropylene braid augmentation. Foot Ankle Int 1994;15(7):372-375.