Biomechanics of tendon healing.

The biomechanics of tendon healing was investigated with unsutured rat achilles tendons. After two, three, and four weeks of healing tensile parameters were assayed with a bone-muscle-tendon-bone preparation elongated to failure at a controlled physiological strain rate. In the third week of healing, stiffness, strength, and energy absorbing capacity all increased approximately 50%. These changes correlated with early fibroplasia. In the fourth week of healing, strength, energy absorbing capacity and elongation to failure all increased relatively more than stiffness. Histologically, larger fibers with better longitudinal alignment developed during this period. At the end of four weeks the tendon's strength was approximately 25% of normal. To summarize, the return of stiffness in a healing tendon preparation correlated with the presence of fibroplasia and the return of other tensile parameters was a function of the amount and organization of the fibroplasia.