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Whether cancellous bone fixation upon this technique could accelerate tendon-to-bone healing is unknown. The purpose of this study is to compare the effect of cortical versus cancellous bone fixation on tendon\u2013bone healing with a novel rat trans-calcaneal suture model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Trans-calcaneal suture treatment was carried out on the right hindlimb in male Sprague\u2013Dawley rats (<jats:italic>N<\/jats:italic>\u2009=\u200980). They were randomly divided into the cortical group (Achilles fixed to the calcaneal cortical bone, <jats:italic>n<\/jats:italic>\u2009=\u200940) and the cancellous group (Achilles fixed to the calcaneal cancellous bone, <jats:italic>n<\/jats:italic>\u2009=\u200940). Gait analysis and immunohistochemistry were performed 1, 4, 7, and 14\u00a0days after the operation. Gross observation, biomechanical analysis, micro-CT, and histological analysis were performed 4 and 8\u00a0weeks after surgery. Independent-samples <jats:italic>t<\/jats:italic> tests were used for comparison between groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>At 1, 4, and 7\u00a0days, the swing time of the affected limb in the cancellous group decreased, while the duty cycle, the maximum contact area, the print area, and the mean intensity increased significantly. The cross-sectional area of the tendon\u2013bone junction in the cancellous group was smaller, and the failure load and stiffness were higher 4\u00a0weeks after the operation. The cancellous group showed more proportion of new bone and a relatively well-organized and dense connective tissue interface with better fibrocartilage-like tissue at 4\u00a0weeks after the operation. The ratio of ED2\u2009+\u2009macrophages in the cancellous group was significantly higher than in the cortical group on 1, 4, 7, and 14\u00a0days. There were no significant differences in gait at 2\u00a0weeks, in appearance, biomechanics, new bone formation, and histology at 8\u00a0weeks after surgery between the two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In the new rat trans-calcaneal suture model, cancellous fixation can accelerate tendon-to-bone healing in the early stage, which perhaps is related to the abundant bone marrow tissue in the cancellous bone that modulates the inflammatory processes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13018-022-03469-8","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T17:05:48Z","timestamp":1672938348000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of cortical versus cancellous bone fixation in tendon-to-bone healing with a rat trans-calcaneal suture model for Achilles tendon sleeve avulsion"],"prefix":"10.1186","volume":"18","author":[{"given":"Shang","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjiao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiqiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanglai","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"3469_CR1","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1177\/107110070402500713","volume":"25","author":"C Bibbo","year":"2004","unstructured":"Bibbo C. 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