Subscribe to RSS
DOI: 10.1055/a-2812-5029
Gap Formation in Achilles Tendon Reinsertion in Cats: A Comparative Ex Vivo Study of Bone Tunnel and a Bioabsorbable Suture Anchor
Authors
Funding Information All anchors used in this study were donated by VetWelding AG. Furthermore, an honorarium for conducting the work was received by P.J.T. utilized to cover funding for salaries of an MSc Student, and partially also for a PhD student (K-H.V.), as well as further time spent on designing and supervising the study by P.J.T. In further detail, the honorarium was used to cover costs for developing the mechanical testing setup, consumables, conducting tests, analysing data, and in-person and online meetings to discuss project progress and mitigate project risks. All financial payments of VetWelding in this context were made to the university.
Abstract
Objective
This study aimed to compare gap formation between a classical transcalcaneal bone tunnel and a bioabsorbable suture anchor in a feline Achilles tendon avulsion model.
Study Design
Gastrocnemius tendons were dissected from the calcaneus of seven pairs of feline gastrocnemius tendon–calcaneus specimens. Reinsertion was performed either through a transverse bone tunnel or with a bioabsorbable suture anchor with a metric 3 non-absorbable monofilament polypropylene–polyethylene suture in a Bunnell–Mayer pattern. Tensile tests were conducted under physiological loading conditions. Gap formation was tracked with a video camera, and force on the tendon was measured. Results were compared with t-tests.
Results
Mean load at a gap of 0.5 mm was significantly higher for the suture anchor (44.2 ± 5.5 N) compared with the bone tunnel (23.0 ± 15.4 N). A 3-mm gap was not reached with the suture anchor. Failure loads were dominated by suture breakage and were not significantly different between suture anchor (55.2 ± 8.0 N) and bone tunnel (65.1 ± 8.3 N). Pulling through the tendon substance did not occur.
Conclusion
The suture anchor resisted gap formation more effectively than the bone tunnel and can be considered advantageous for gastrocnemius tendon reinsertion in cats.
Keywords
Achilles tendon avulsion - bone anchor - bioabsorbable suture anchor - gastrocnemius tendinopathy - common calcaneal tendinopathyContributors' Statement
F.G. contributed to data curation, formal analysis, investigation, software, validation, visualization, writing–original draft, writing–review and editing. K.H-V. contributed to conceptualization, investigation, methodology, supervision, validation. P.J.T. contributed to conceptualization, data curation, funding acquisition, investigation, methodology, project administration, supervision, writing–original draft, writing–review and editing. R.S. contributed to conceptualization, data curation, investigation, methodology, project administration, resources, supervision, writing–original draft, writing–review and editing.
Publication History
Received: 01 April 2025
Accepted: 11 February 2026
Article published online:
24 February 2026
© 2026. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Voss K, Montavon P, Langley-Hobbs S. Rupture or avulsion of the Achilles tendon. In: Feline Orthopedic Surgery and Musculoskeletal Disease. Saunders; 2009. :p. 509
- 2 Cervi M, Brebner N, Liptak J. Short- and long-term outcomes of primary Achilles tendon repair in cats: 21 cases. Vet Comp Orthop Traumatol 2010; 23 (05) 348-353
- 3 Häußler TC, Kornmayer M, Scheich M, Fischer A, Feichtenschlager CJ, Rohwedder T. Retrospective multicentre evaluation of common calcaneal tendon injuries in 66 cats. Part 1: Study population, injury specification and classification. J Feline Med Surg 2023; 25 (01) X221131253
- 4 Häußler TC, Kornmayer M, Scheich M, Fischer A, Feichtenschlager CJ, Rohwedder T. Retrospective multicentre evaluation of common calcaneal tendon injuries in 66 cats. Part 2: Treatment, complications and outcomes. J Feline Med Surg 2023; 25 (01) X221131224
- 5 DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. 14 - Fractures and other orthopedic conditions of the carpus, metacarpus, and phalanges. In: DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. eds. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair (Fifth Edition). W.B. Saunders; 2016. :pp. 389-433
- 6 Gelberman RH, Boyer MI, Brodt MD, Winters SC, Silva MJ. The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs. J Bone Joint Surg Am 1999; 81 (07) 975-982
- 7 Nielsen C, Pluhar GE. Outcome following surgical repair of Achilles tendon rupture and comparison between postoperative tibiotarsal immobilization methods in dogs: 28 cases (1997-2004). Vet Comp Orthop Traumatol 2006; 19 (04) 246-249
- 8 Gutbrod A, Knell S, Schmierer P, Pozzi A. A comparison of new repair techniques for tarsal medial collateral ligaments in cats: A cadaveric feasibility study. Vet Comp Orthop Traumatol 2018; 31 (02) A1-A25
- 9 Langhoff JD, Kuemmerle JM, Mayer J. et al. An ultrasound assisted anchoring technique (BoneWelding technology) for fixation of implants to bone - A histological pilot study in sheep. Open Orthop J 2009; 3: 40-47
- 10 Kastenberger T, Kaiser P, Schmidle G, Stock K, Benedikt S, Arora R. Clinical results of the BoneWelding®Fiji® anchor for the treatment of Stener lesions of the thumb. Arch Orthop Trauma Surg 2021; 141 (09) 1499-1507
- 11 VetWelding AG. White Paper 1 - Introduction and Summary of BoneWelding® Implant Technology; What makes it superior to metal implants?. 2021 . Accessed February 17, 2026 at: https://www.vetwelding.com/wp-content/uploads/2022/09/VetWelding-WP1_PLDLLA_Summary.pdf
- 12 Schuenemann R, Strauss S. Biceps tenodesis with a bioabsorbable bone anchor using BoneWelding technology: Results in six clinical cases (5 dogs). Vet Surg 2025; 54 (04) 799-806
- 13 Bunnel S. Repair of tendons in the fingers and description of two new instruments. Surg Gynecol Obstet 1918; 26: 103-110
- 14 Moores AP, Owen MR, Tarlton JF. The three-loop pulley suture versus two locking-loop sutures for the repair of canine Achilles tendons. Vet Surg 2004; 33 (02) 131-137
- 15 Jordan MC, Hoelscher-Doht S, Fehske K, Gilbert F, Jansen H, Meffert RH. Bunnell or cross-lock Bunnell suture for tendon repair? Defining the biomechanical role of suture pretension. J Orthop Surg Res 2015; 10: 192
- 16 Putterman AB, Duffy DJ, Kersh ME, Rahman H, Moore GE. Effect of a continuous epitendinous suture as adjunct to three-loop pulley and locking-loop patterns for flexor tendon repair in a canine model. Vet Surg 2019; 48 (07) 1229-1236
- 17 Cocca CJ, Duffy DJ, Kersh ME, Kim W, Groenewold A, Moore GE. Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries. Vet Surg 2019; 48 (07) 1245-1252
- 18 Dunlap AE, Kim SE, McNicholas Jr WT. Biomechanical evaluation of a non-locking pre-manufactured loop suture technique compared to a three-loop pulley suture in a canine calcaneus tendon avulsion model. Vet Comp Orthop Traumatol 2016; 29 (02) 131-135
- 19 Moores AP, Comerford EJ, Tarlton JF, Owen MR. Biomechanical and clinical evaluation of a modified 3-loop pulley suture pattern for reattachment of canine tendons to bone. Vet Surg 2004; 33 (04) 391-397
- 20 Wilson L, Banks T, Luckman P, Smith B. Biomechanical evaluation of double Krackow sutures versus the three-loop pulley suture in a canine gastrocnemius tendon avulsion model. Aust Vet J 2014; 92 (11) 427-432
- 21 Duffy DJ, Chang YJ, Fisher MB, Moore GE. Effect of partial vs complete circumferential epitendinous suture placement on the biomechanical properties and gap formation of canine cadaveric tendons. Vet Surg 2020; 49 (08) 1571-1579
- 22 Cocca CJ, Duffy DJ, Kersh ME, Moore GE. Influence of interlocking horizontal mattress epitendinous suture placement on tendinous biomechanical properties in a canine common calcaneal laceration model. Vet Comp Orthop Traumatol 2020; 33 (03) 205-211
- 23 VetWelding AG. Impantation in cold versus warm water; 2017
