Purpose
To assess clinical outcomes following pectoralis major tendon (PMT) repairs and to
compare outcomes of PMT repairs augmented with and without leukocyte-poor platelet-rich
plasma (LP-PRP).
Methods
A retrospective review of prospectively collected data was performed of patients who
underwent a PMT repair from May 2007 to June 2019 with a minimum of 2-year follow-up.
Exclusion criteria included revision PMT repair, PMT reconstruction, and concomitant
repair of another glenohumeral tendon/ligament. LP-PRP was injected surrounding the
PMT repair before wound closure. Patient-reported outcome (PRO) data were collected
preoperatively and evaluated at final follow-up using the American Shoulder and Elbow
Surgeons Score (ASES), Single Assessment Numeric Evaluation Score (SANE), Quick Disabilities
of the Arm, Shoulder and Hand Score (QuickDASH), and Short Form 12 physical component
summary (SF-12 PCS), patient satisfaction with outcomes.
Results
Twenty-three men (mean age, 38.6 years; range, 20.5-64.3 years) were included in the
final analysis. Mean time from injury to surgery was 30 days (range, 3-123 days).
Follow-up was obtained for 16 of 23 patients (70%) at a mean of 5.1 years (range 2.0-13.0
years). Significant improvement in PROs was observed (ASES: 59.0 → 92.4, P = .008; SANE: 44.4 → 85.9, P = .018; QuickDASH: 44.4 → 8.5, P = .018; and SF-12 PCS: 42.5 → 52.6, P = .008). Median satisfaction was 9 of 10 (range, 6-10). Patients receiving LP-PRP
had superior ASES (99.6 vs 83.0, P = .001), SANE (94.8 vs 74.6, P = .005), QuickDASH (0.24 vs 19.1, P = .001), and patient satisfaction (10 vs 9, P = .037) scores compared with those without PRP. PROs were unchanged based on chronicity,
mechanism of injury, or tear location. One patient had revision surgery at 3.4 years
due to adhesions.
Conclusions
PMT repair produces improved PROs at final follow-up when compared with preoperative
values.
Level of Evidence
Level III, retrospective comparative therapeutic trial.
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Article info
Publication history
Published online: September 06, 2022
Accepted:
June 28,
2022
Received:
April 8,
2022
Footnotes
The authors report the following potential conflicts of interest or sources of funding: J.A.H., M.P.H., K.E.W., D.R.R., A.M.P., report personal fees from Steadman Philippon Research Institute, outside the submitted work. J.J.E. reports personal fees from Johnson & Johnson, United States and DePuy Mitek Sports Medicine, outside, United States the submitted work. M.T.P. reports personal fees from Arthrex, Joint Surface Foundation, SLACK Inc., and Arthrosurface, during the conduct of the study; is an editorial or governing board member for Arthroscopy, Knee, Orthopedics, and SLACK Inc.; and is a board or committee member for AANA, American Academy of Orthopaedic Surgeons, United States, American Orthopaedic Society for Sports Medicine, United States, American Shoulder and Elbow Surgeons, United States, International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, United States, the San Diego Shoulder Institute, and the Society of Military Orthopaedic Surgeons. P.J.M. reports grants, personal fees, and other from Arthrex, United States; personal fees from Springer Publishing and from Medbridge; other from VuMedi, ProofPoint Biologics, Steadman Philippon Research Institute, United States, Smith & Nephew, Siemens, Germany, and Ossur, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Research was performed at the Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
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