Pectoralis major tendon tears: functional outcomes and return to sport in a consecutive series of 40 athletes

• Published in: Journal of shoulder and elbow surgery 2017-03, Vol.26 (3), p.458-463
• Main Authors: Cordasco, Frank A., MD, MS, Mahony, Gregory T., BA, Tsouris, Nicholas, BA, Degen, Ryan M., MD
• Format: Article
• Language: English
• Subjects: Adult; Athletes; clinical outcome; Female; Follow-Up Studies; Humans; Male; Middle Aged; Muscle Strength; Orthopedics; Patient Satisfaction; pectoralis major; Pectoralis Muscles - injuries; Reoperation; Retrospective Studies; Return to Sport; Shoulder; surgical repair; tendon injuries; Tendon Injuries - surgery; tendon repair; Young Adult
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2016.07.018

Background There are limited data on the outcomes of surgically repaired pectoralis major tendon (PMT) tears. The purpose of this study was to report the functional outcomes, return to sport, and second surgery rates in a consecutive series of PMT tears. Methods Forty patients with acutely repaired PMT tears were retrospectively identified. Follow-up was conducted with functional outcome scores and adduction strength testing at final follow-up. Return to sport and incidence of subsequent surgery were also recorded. Results The average age of the patients was 34.4 years (range, 23-59 years). Average follow-up was 2.5 years (range, 2-7.0 years). Twenty-three injuries (58%) occurred in the nondominant extremity. Bench press (n = 26) and contact sport participation (n = 14) were the most common mechanisms. Postoperative Single Assessment Numeric Evaluation scores averaged 93.6 (range, 62-100), with patient satisfaction of 9.6 of 10 (range, 6-10). All athletes returned to preinjury level of function approximately 5.5 months postoperatively (range, 4.5-6.5 months); 23.1% and 2.6% described mild or moderate difficulties with sport participation. Isokinetic strength evaluation revealed an average decrease of 9.9% (range, −18% to 41%). Application of the Bak criteria revealed 37% excellent, 26% good, and 37% fair outcomes, with most in the fair group reporting cosmetic concerns. Removing cosmesis, 46% scored excellent, 37% good, and only 17% fair. Three athletes required a second surgical procedure (7.5%). Conclusions Surgical repair of PMT tears resulted in high patient satisfaction, with excellent restoration of function and adduction strength, early return to sport, and few reoperations, albeit with the potential for mild cosmetic concerns.