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Pectoralis Major Tendon Reconstruction: A Systematic Review
Phillip R Schneider1, Michael D Eckhoff1, Logan R Koehler1
1Department of Orthopedics, William Beaumont Army Medical Center, El Paso, Texas.
Insights
Pectoralis major tendon reconstruction effectively restores function for retracted tears. This surgical technique offers good to excellent outcomes, with a high rate of return to sports activity.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Research
Background:
- Pectoralis major tendon injuries are uncommon but can require complex reconstruction if retracted.
- Primary repair is suitable for acute tears, while chronic or retracted tears necessitate tendon reconstruction.
Purpose of the Study:
- To systematically review patient characteristics, surgical techniques, and outcomes of pectoralis major tendon reconstruction.
- To evaluate the efficacy of pectoralis major reconstruction for tears not amenable to primary repair.
Main Methods:
- Systematic review of peer-reviewed studies published between 1990 and 2019.
- Inclusion criteria required a minimum 1-year follow-up.
- Primary outcomes included return to activity, range of motion, complications, and functional scores.
Main Results:
- Fourteen studies with 88 male patients (average age 34.6 years) were included.
- Hamstring autograft was the most common graft (35 cases).
- Good to excellent functional outcomes were reported in the majority of patients, with 94.2% returning to sport.
Conclusions:
- Pectoralis major tendon reconstruction is a viable surgical option for retracted tears.
- The procedure demonstrates high success rates for restoring function and enabling return to sport.
- Further research may explore optimal graft choices and long-term outcomes.
Abstract:
Pectoralis major tendon injuries are an uncommon injury. They can be treated with primary repair, however, when the tendon becomes retracted it necessitates tendon reconstruction. We performed a systematic review to evaluate patient characteristics, surgical techniques, and outcomes associated with pectoralis major reconstruction. A review was performed for studies published between 1990 and 2019. Peer-reviewed studies with a minimum 1-year follow-up were included. Return to activity, range of motion, complications, and functional outcome scores were primary outcomes. Fourteen primary studies with 88 total patients met inclusion criteria. All patients were male with the average age of 34.6 years-old. Hamstring autograft represented the most frequently used graft type (35). Functional outcomes demonstrated good to excellent results in the majority of patients. Pectoralis major tendon reconstruction is a viable option for tears not amenable to primary repair. We found good to excellent outcomes, and 94.2% return to sport for patients undergoing reconstruction. (Journal of Surgical Orthopaedic Advances 31(2):123-126, 2022).