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Healing of a lengthened tendon is typically supported by casting and unloading of the operated limb. Although tendon rupture or overcorrection may adversely affect surgical outcomes, few studies have examined surgical means of improving post-operative stability of the tendon. We aim to evaluate a novel method for augmenting Z-Plasty tendon lengthening as a first step to clinical translation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this experimental ex vivo study, we employed a bovine flexor tendon model (<jats:italic>n<\/jats:italic>\u2009=\u200918) to examine a novel mechanical augmentation method after tendon lengthening by Z-plasty. Conventional surgical suturing of the imposed Z-plasty (<jats:italic>n<\/jats:italic>\u2009=\u20096) and an experimental group (<jats:italic>n<\/jats:italic>\u2009=\u20096), in which additional augmentation was performed by interlocking fibres of a biomaterial scaffold to the underlying tendon using a novel micro-needling technique, were compared to native tendons (<jats:italic>n<\/jats:italic>\u2009=\u20096).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The needle interlocked scaffold successfully augmented the suture repair, showing more than doubled ultimate failure force compared to controls (482\u2009\u00b1\u2009107 N vs. 206\u2009\u00b1\u200937 N, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and more than 1.5-fold repair stiffness (41\u2009\u00b1\u20097 N\/mm vs. 26\u2009\u00b1\u20099 N\/mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We conclude that the use of an interpenetrating biomaterial scaffold represents a promising new approach for improving biomechanical tendon properties, which may have an implication on the stability of tendon suture, lengthening and tendon transfer procedures as well as on post-operative management and earlier mobilization.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00264-025-06481-9","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T18:39:31Z","timestamp":1742495971000},"page":"1055-1063","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reinforced lengthening Achilles tendon Z-plasty \u2013 ex vivo assessment of biomechanical augmentation with surgical-fiberlock technology"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4166-5207","authenticated-orcid":false,"given":"Thomas","family":"Dreher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5657-4727","authenticated-orcid":false,"given":"Andrea","family":"Moehl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1422-3104","authenticated-orcid":false,"given":"Elias","family":"Bachmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5676-6839","authenticated-orcid":false,"given":"Arend","family":"Nieuwland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-0275","authenticated-orcid":false,"given":"Jess G.","family":"Snedeker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"issue":"3","key":"6481_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1302\/1863-2548.15.210033","volume":"15","author":"P Wong","year":"2021","unstructured":"Wong P, Fransch S, Gallagher C, Francis KL, Khot A, Rutz E et al (2021) Split anterior tibialis tendon transfer to peroneus brevis for spastic equinovarus in children with hemiplegia. 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No further approval of the local ethical Review Committee was needed, as no live animal data were used. The bovine flexor tendons were obtained from a local abattoir.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Review Committee Statement"}},{"value":"Andrea Moehl and Elias Bachmann are employees of ZuriMED technologies, the manufacturer of Surgical Fiberlock Technology. Jess Snedeker is founder of and shareholder in ZuriMED Technologies AG, the manufacturer of Surgical Fiberlock Technology.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}