Using the xenopericardium for the Achilles tendon reconstruction 

Stanislav V. Sivakon, Doctor of medical sciences, associate professor, head of the sub-department of traumatology, orthopedics and military extreme medicine, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: sivakon@mail.ru
Sergey V. Sretenskiy, Senior lecturer of the sub-department of traumatology, orthopedics and military extreme medicine, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: sretenskiy141084@mail.ru
Ekaterina A. Sretenskaya, Assistant of the sub-department of medical cybernetics and computer science, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: sretenskiy141084@mail.ru
Anastasiya M. Vasina, Student, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: nastya2011013@gmail.com 

Background. The rupture of the distal tendon part of the calf muscle accounts for 48% of all tendon structures of the human body. The problem of restoring the integrity of the tendon is far from being solved today. The main disadvantage of the existing types of plastic and sutures of the Achilles tendon is the lack of a solution to the problem of restoring the smooth surface of the tendon. The purpose of the study is to improve the results of surgical treatment of closed subcutaneous degenerative ruptures of the Achilles tendon. Materials and methods. In order to determine the possibility of using xenopericardium transplants for plastic surgery of the distal part of the calf muscle, 2 series of experiments were conducted. In the first series of experiments, its biointegation in animal tissues was investigated. In the second series of experiments, a comparative study of the mechanical strength of the cadaveric material of the tendon part of the calf muscle and xenopericardium grafts for rupture and the features of their eruption with suture material was carried out. We have developed two new methods of plasticizing the distal tendon part of the calf muscle with xenopericardium grafts for fresh and long-standing Achilles tendon ruptures for which two patents of the Russian Federation have been obtained. Results. As a result of the conducted research, it is proved that the plastic material is biocompatible with living tissues. The mechanical properties of the xenopericardium have twice the tear and eruption strength compared to the cadaveric material. 21 patients were operated with new methods. The results of treatment were evaluated according to the method proposed by Leppilahti J. (1998). Conclusions. Excellent (in 85.7% of cases) and good (in 14.3% of cases) results were obtained in patients whose surgical treatment used plastic material xenopericardium. This is due, in our opinion, to the full restoration of the smooth surface of the distal tendon part of the calf muscle. 

Achilles tendon, plastic, xenopericard 

Sivakon' S.V., Sretenskiy S.V., Sretenskaya E.A., Vasina A.M. Using the xenopericardium for the Achilles tendon reconstruction. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2023;(4):30–41. (In Russ.). doi: 10.21685/2072-3032-2023-4-4