Single-Row vs Double-Row Repair for Achilles Tendinopathy

(STRIDE Trial)

DB
Overseen ByDidem Bozak
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Women's College Hospital
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two surgical methods for fixing Achilles tendinopathy, a painful condition where the Achilles tendon meets the heel bone. The researchers aim to determine if the double-row repair, which uses more anchors, leads to better healing than the single-row repair. This trial is important for individuals who have had this condition for at least three months and haven't improved with treatments like physical therapy or medication. Participants must be willing to follow a specific rehab plan and attend follow-up appointments. As an unphased trial, it offers participants the opportunity to contribute to valuable research that could improve future treatment options.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you've used oral steroids or had a steroid injection within 3 months of surgery.

What prior data suggests that these surgical techniques are safe for Achilles tendinopathy?

Research shows that both single-row and double-row methods for repairing the Achilles tendon are generally safe for treating insertional Achilles tendinopathy. Studies on the double-row method indicate it is effective and well-tolerated, with many patients reporting high satisfaction and improved ability to play sports after surgery. The single-row method is also commonly used and poses no significant safety concerns. Both techniques use small anchors to reattach the tendon, and current research reveals no major negative effects for either method.12345

Why are researchers excited about this trial?

Researchers are excited about these Achilles tendon repair methods because they aim to improve the way tendons heal after injury. Traditional repair often uses a single-row technique, which involves two suture anchors. However, the double-row repair technique, using four anchors in total, might better mimic the tendon’s natural attachment and provide stronger fixation. This could potentially lead to better healing outcomes, reduced re-injury rates, and quicker recovery times, offering a significant advantage over the current standard treatments.

What evidence suggests that this trial's treatments could be effective for Achilles tendinopathy?

This trial will compare single-row and double-row repair techniques for Achilles tendinopathy. Research has shown that repairing the Achilles tendon with a double-row technique often leads to better results than a single-row technique. Patients typically experience less pain and improved quality of life after surgery with the double-row method. Studies have found that double-row repairs create a stronger bond, potentially resulting in fewer failures and better healing. However, the improvement over single-row repair isn't always clear, as some research indicates both methods can lead to similar functional outcomes. Patient-reported outcomes, such as quality of life, tend to improve significantly over time with double-row repairs. While single-row repair is generally effective, some studies suggest it might not be as durable under stress compared to double-row repair.23678

Who Is on the Research Team?

SS

Si-Hyeong Sam Park, MD, FRCPC

Principal Investigator

Women's College Hospital

Are You a Good Fit for This Trial?

This trial is for adults aged 18-75 with chronic Achilles insertional tendinopathy, unresponsive to non-operative treatments like physiotherapy and NSAIDs for at least 3 months. Participants must understand the study, agree to its procedures, follow a post-op rehab protocol, and commit to follow-ups for up to 2 years.

Inclusion Criteria

I have signed the informed consent form.
I am willing to follow all study procedures.
I have completed preoperative x-ray and MRI scans.
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo either single-row or double-row surgical repair for Achilles insertional tendinopathy

Surgery day
1 visit (in-person)

Follow-up

Participants are monitored for clinical outcomes using the VISA-A score and other measures

24 months
Regular follow-up visits

What Are the Treatments Tested in This Trial?

Interventions

  • Double-row repair of the Achilles tendon at its calcaneal insertion
  • Single-row repair of the Achilles tendon at its calcaneal insertion

Trial Overview

The trial compares two surgical techniques for reattaching the Achilles tendon after debridement: single-row versus double-row repair. It aims to determine which method provides better outcomes using the VISA-A score in a cost-effective manner.

How Is the Trial Designed?

2

Treatment groups

Active Control

Group I: Single-row repair ArmActive Control1 Intervention
Group II: Double-row repair ArmActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Women's College Hospital

Lead Sponsor

Trials
108
Recruited
43,700+

The Physicians' Services Incorporated Foundation

Collaborator

Trials
165
Recruited
31,700+

Unity Health Toronto

Collaborator

Trials
572
Recruited
470,000+

University of Toronto

Collaborator

Trials
739
Recruited
1,125,000+

University Health Network, Toronto

Collaborator

Trials
1,555
Recruited
526,000+

Citations

Reinforcement of the Achilles Tendon Double-Row Repair

Patient-reported outcomes related to quality of life at 1 year posttreatment and beyond have also been documented as significantly improved over preoperative ...

Review of Achilles Tendon Reattachment Using Double ...

In the present study, we evaluate the results of knotted and knotless double-row suture systems for Achilles reattachment. Despite the ...

The Double‐Row Suture Technique: A Better Option for ...

(a) 50–70% of the Achilles insertion was detached without compromising the tendon. The calcified lesions were excised. (b) A suture anchor was ...

A comparative study of single-vs. double-row technique in ...

This study compared the functional results of single-row and double-row surgical techniques for treating insertional tendinopathy of the ...

Single-Row Repair Versus Double ...

Clinical outcomes following surgical management of insertional Achilles tendinopathy using a double-row suture bridge technique with mean two- ...

Central Tendon-Splitting Approach and Double Row Suturing ...

It can be a safe and effective method for the treatment of insertional Achilles tendinopathy.

Achilles tendon debridement, calcaneoplasty and double ...

Our study shows improvement in postoperative sports ability and high patient satisfaction after insertional Achilles tendon debridement, and double-row tendon ...

Single-Row Repair Versus Double-Row Repair in the Surgical ...

Biomechanical comparison found that there was a significant advantage to using double-row versus single-row fixation with respect to load at yield.