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Pectoralis Tendon Repair

Injury to the pectoralis muscle affects shoulder mechanics and the ability to perform daily life activities. Tears of the pectoralis major tendon typically affect young, active males often caused by weight lifting or sports that involve throwing and pushing movements.  Pectorals tendon ruptures may be acute or chronic and can lead to deformity and physical disability if left untreated.

After the surgery, the patient will need to wear a sling or brace to protect the repair site and limit movement. They may also be given pain medication and other medications to prevent infection and promote healing. Rehabilitation will typically begin a few weeks after the surgery and will involve a structured program of physical therapy and exercise to help restore strength, flexibility, and range of motion. The duration and intensity of the rehabilitation program will depend on the patient’s specific injury and individual needs.

Surgical intervention is warranted to restore full shoulder range of motions and strength. The medical literature has found that surgery yields excellent functional and cosmetic results.

The goal of the surgery is to reattach the torn tendon to the bone, which will allow restore anatomy and biomechanics so the muscle to function properly.  The surgical procedure can be performed as an open surgery or with the use of arthroscopy.

Studies report that surgery before six weeks from injury has better reported outcomes than surgery between six and eight weeks. When surgery is delayed beyond eight weeks, it increases the likelihood of reconstruction with a graft or tendon transfer.

Surgery involves reattaching the torn tendon to the bone in its original anatomical position. Anatomical tendon repair refers to a surgical technique in which a torn or ruptured tendon is repaired by reattaching it to the bone in its original anatomical position.

The specific technique used will depend on the location and severity of the tear, timing of surgery and the surgeon’s preference and experience. Here is a general overview of the steps involved in the surgical repair of a complete pectoralis tendon tear:

  1. Anesthesia: The patient is given general anesthesia, which will put them to sleep and prevent them from feeling any pain during the procedure.
  2. Incision: The surgeon makes an incision in the shoulder to expose the torn tendon and the upper arm bone ( the humerus) to which it was attached.
  3. Tendon Preparation: The torn ends of the pectoralis tendon are then prepared for reattachment. This may involve removing any scar tissue or debris from the torn ends and preparing the bone surface for optimal healing.
  4. Tendon Transfer: In cases where the pectoralis tendon is too damaged to repair, the surgeon may use a tendon transfer technique. This involves taking a tendon from another part of the body, such as the hamstring or the quadriceps, and attaching it to the humerus bone to replace the damaged pectoralis tendon.
  5. Graft Augmentation: In some cases, the surgeon may use a graft to augment the damaged tendon. This involves taking a piece of tissue from another part of the body or using a synthetic material and attaching it to the torn tendon to provide additional support and stability.
  6. Reattachment: The surgeon then reattaches the torn tendon to the bone using sutures, anchors, or other specialized devices. The goal is to restore the tendon to its original anatomical position.
  7. Closure: The incision is then closed using sutures or staples, and a sterile dressing is applied.

Overall, studies have shown that pectoralis tendon repair surgery has a high success rate. One study published in the American Journal of Sports Medicine found that patients who underwent surgery had a return to sport rate of 89% and a satisfaction rate of 94%. Another study published in the Journal of Shoulder and Elbow Surgery reported a return to work rate of 90% and a satisfaction rate of 95%.

Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in diagnosing and treating shoulder injuries. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.

At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
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