Pectoralis major tendon transfer for irreparable subscapularis tears

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research
• Reconstructive Procedures

Background:

• Subscapularis insufficiency presents a significant clinical challenge with limited therapeutic options.
• Pectoralis major tendon transfer is a historical salvage procedure for irreparable subscapularis injuries, yielding variable outcomes.

Purpose of the Study:

• To comprehensively review the literature on pectoralis major tendon transfers for subscapularis insufficiency.
• To analyze surgical indications, techniques, outcomes, and complications associated with this procedure.

Main Methods:

• A systematic review of peer-reviewed studies on pectoralis major tendon transfers was conducted.
• The review encompassed clinical presentation, anatomy, biomechanics, surgical details, and outcomes.
• Comparative analysis of outcomes based on surgical techniques and indications was performed where feasible.

Main Results:

• Outcomes of pectoralis major tendon transfer are strongly influenced by the underlying surgical indications.
• Isolated subscapularis insufficiency demonstrates the most favorable prognosis following transfer.
• Patients with anterosuperior instability post-rotator cuff repair or arthroplasty experience less predictable pain relief and functional improvement.

Conclusions:

• The efficacy of pectoralis major tendon transfer is indication-dependent.
• Optimal outcomes are observed in cases of isolated subscapularis insufficiency.
• Suboptimal results are associated with anterosuperior instability, necessitating careful patient selection.