Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft
Background: Pectoralis major tendon (PMT) ruptures are on the rise. Although early surgical repair of PMT ruptures is recommended, some present in a delayed manner, making chronic ruptures more challenging to repair. Although multiple techniques involving different grafts and fixation methods have b...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | JSES Reviews, Reports, and Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639125000471 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849706539131076608 |
|---|---|
| author | Abdul-ilah Hachem, MD Diego Gonzalez-Morgado, MD Peio Beristain, MD Gonzalo Barraza, MD Fernando Alvarado, MD Karla Bascones, MD Amr Elmaraghy, MD Xavi Rius, MD |
| author_facet | Abdul-ilah Hachem, MD Diego Gonzalez-Morgado, MD Peio Beristain, MD Gonzalo Barraza, MD Fernando Alvarado, MD Karla Bascones, MD Amr Elmaraghy, MD Xavi Rius, MD |
| author_sort | Abdul-ilah Hachem, MD |
| collection | DOAJ |
| description | Background: Pectoralis major tendon (PMT) ruptures are on the rise. Although early surgical repair of PMT ruptures is recommended, some present in a delayed manner, making chronic ruptures more challenging to repair. Although multiple techniques involving different grafts and fixation methods have been described, a standardized approach is lacking. This study aimed to report the clinical outcomes of patients who underwent reconstruction of chronic PMT ruptures using Achilles tendon allograft fixed with implant-free transosseous sutures. Methods: A retrospective review of patients who underwent PMT reconstruction with a minimum follow-up of 2 years. Patient demographics, delay in diagnosis and treatment, and follow-up were recorded. Patient-reported outcome measures were recorded at baseline and the final follow-up. These outcomes included the American Shoulder and Elbow Surgeons score, visual analog scale for pain, Constant score, and subjective shoulder value. At the last follow-up, the postoperative ranges of motion and adduction isometric strength were compared with those of the uninjured arm. Additionally, postoperative complications, return-to-previous activities, cosmetic appearance, and overall patient satisfaction were documented. Results: Four male patients with a median age of 46.5 years (29-52) were included. The mean delay in diagnosis and treatment was 5.5 months (2-12) and 12 ± 4.9 months, respectively. The overall cohort improved significantly regarding pain (visual analog scale: −6 [95% CI: −2.3 to −9.7], P = .014) and patient-reported outcome measures (American Shoulder and Elbow Surgeons: 23 [95% CI: 14.6-31.4], P = .003; Constant score: 38.8 [95% CI: 9.3-68.2], and P = .025; subjective shoulder value: 45 [95% CI: 0.5-89.5], P = .049). All patients had full range of motion with no differences between the sides (forward flexion: 180° ± 0, external rotation 81° ± 9, and internal rotation: T7 ± 1). The mean adduction strength for the injured side was 21 ± 3.9 kg, with no difference compared to the uninjured side (21 ± 6.7 kg, P = 1). All patients were satisfied and returned to their previous activities; no postoperative complications were reported. Conclusion: Chronic PMT rupture reconstruction with Achilles tendon allograft fixed with implant-free transosseous sutures provides excellent clinical outcomes and strength restoration with high satisfaction and low complication rates. |
| format | Article |
| id | doaj-art-961896e07f3148a1a408fece0484362f |
| institution | DOAJ |
| issn | 2666-6391 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj-art-961896e07f3148a1a408fece0484362f2025-08-20T03:16:10ZengElsevierJSES Reviews, Reports, and Techniques2666-63912025-08-015355956610.1016/j.xrrt.2025.03.002Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograftAbdul-ilah Hachem, MD0Diego Gonzalez-Morgado, MD1Peio Beristain, MD2Gonzalo Barraza, MD3Fernando Alvarado, MD4Karla Bascones, MD5Amr Elmaraghy, MD6Xavi Rius, MD7Department of Orthopaedic Surgery and Traumatology, Bellvitge University Hospital, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Corresponding author: Abdul-ilah Hachem, MD, Department of Orthopaedic Surgery and Traumatology, Bellvitge University Hospital, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona Carrer de la Feixa Llarga, s/n, Barcelona 08907, Spain.Orthopaedic Surgery Department, Hospital Universitari Vall d’Hebron, Universitat Autonoma de Barcelona, Barcelona, SpainHospital de Tortosa, Verge de la Cinta, Tarragona, SpainDepartment of Orthopaedic Surgery and Traumatology, Bellvitge University Hospital, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, SpainDepartment of Orthopaedic Surgery and Traumatology, Bellvitge University Hospital, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, SpainDepartment of Orthopaedic Surgery and Traumatology, Bellvitge University Hospital, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, SpainDepartment of Orthopedic Surgery, St Joseph's Health Centre, University of Toronto, Toronto, ON, CanadaDepartment of Orthopaedic Surgery and Traumatology, Bellvitge University Hospital, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, SpainBackground: Pectoralis major tendon (PMT) ruptures are on the rise. Although early surgical repair of PMT ruptures is recommended, some present in a delayed manner, making chronic ruptures more challenging to repair. Although multiple techniques involving different grafts and fixation methods have been described, a standardized approach is lacking. This study aimed to report the clinical outcomes of patients who underwent reconstruction of chronic PMT ruptures using Achilles tendon allograft fixed with implant-free transosseous sutures. Methods: A retrospective review of patients who underwent PMT reconstruction with a minimum follow-up of 2 years. Patient demographics, delay in diagnosis and treatment, and follow-up were recorded. Patient-reported outcome measures were recorded at baseline and the final follow-up. These outcomes included the American Shoulder and Elbow Surgeons score, visual analog scale for pain, Constant score, and subjective shoulder value. At the last follow-up, the postoperative ranges of motion and adduction isometric strength were compared with those of the uninjured arm. Additionally, postoperative complications, return-to-previous activities, cosmetic appearance, and overall patient satisfaction were documented. Results: Four male patients with a median age of 46.5 years (29-52) were included. The mean delay in diagnosis and treatment was 5.5 months (2-12) and 12 ± 4.9 months, respectively. The overall cohort improved significantly regarding pain (visual analog scale: −6 [95% CI: −2.3 to −9.7], P = .014) and patient-reported outcome measures (American Shoulder and Elbow Surgeons: 23 [95% CI: 14.6-31.4], P = .003; Constant score: 38.8 [95% CI: 9.3-68.2], and P = .025; subjective shoulder value: 45 [95% CI: 0.5-89.5], P = .049). All patients had full range of motion with no differences between the sides (forward flexion: 180° ± 0, external rotation 81° ± 9, and internal rotation: T7 ± 1). The mean adduction strength for the injured side was 21 ± 3.9 kg, with no difference compared to the uninjured side (21 ± 6.7 kg, P = 1). All patients were satisfied and returned to their previous activities; no postoperative complications were reported. Conclusion: Chronic PMT rupture reconstruction with Achilles tendon allograft fixed with implant-free transosseous sutures provides excellent clinical outcomes and strength restoration with high satisfaction and low complication rates.http://www.sciencedirect.com/science/article/pii/S2666639125000471Pectoralis majorAchilles tendonAllograftImplant-freeTransosseous fixationTendon |
| spellingShingle | Abdul-ilah Hachem, MD Diego Gonzalez-Morgado, MD Peio Beristain, MD Gonzalo Barraza, MD Fernando Alvarado, MD Karla Bascones, MD Amr Elmaraghy, MD Xavi Rius, MD Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft JSES Reviews, Reports, and Techniques Pectoralis major Achilles tendon Allograft Implant-free Transosseous fixation Tendon |
| title | Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft |
| title_full | Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft |
| title_fullStr | Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft |
| title_full_unstemmed | Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft |
| title_short | Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft |
| title_sort | outcomes of chronic pectoralis major rupture repair with implant free achilles allograft |
| topic | Pectoralis major Achilles tendon Allograft Implant-free Transosseous fixation Tendon |
| url | http://www.sciencedirect.com/science/article/pii/S2666639125000471 |
| work_keys_str_mv | AT abdulilahhachemmd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT diegogonzalezmorgadomd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT peioberistainmd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT gonzalobarrazamd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT fernandoalvaradomd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT karlabasconesmd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT amrelmaraghymd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft AT xaviriusmd outcomesofchronicpectoralismajorrupturerepairwithimplantfreeachillesallograft |