Outcomes of Pectoralis Major Tendon Repair: Does Study Design Matter?: Commentary on an article by Drew W. Nute, MD, et al.: "Return to Function, Complication, and Reoperation Rates Following Primary Pectoralis Major Tendon Repair in Military Service Members".

Abstract

Nute et al. are to be congratulated for this retrospective study comprising a large cohort of 257 U.S. active-duty military patients following primary pectoralis major tendon repair performed by 152 surgeons at 57 medical treatment facilities between 2008 and 2013, with a minimum follow-up of 2 years. The patients were identified from the Military Health System utilizing the Management Analysis and Reporting Tool (M2). Historically, pectoralis major tendon tears have occurred infrequently. A systematic review identified only 365 cases in the literature since Patissier’s description of the injury in 1822 through 20101. Pectoralis major tendon tears have occurred with increasing frequency in more recent years. Changing demographic characteristics with increased participation in contact sports and weight-training activities are likely responsible. Previous studies have demonstrated that improved outcomes can be anticipated with surgical repair compared with nonoperative treatment and that acute repair is preferable2-4. Recent publications have begun to provide more information on anticipated functional outcomes, adduction strength following surgical repair, complications, and second surgical procedure rates5. The strengths of this study from Nute et al. include the large cohort of patients and the information provided with regard to functional outcomes, complications, reoperation rates, and risk factors for failure. A total of 242 patients (94%) were able to return to full duty at a mean time of 7.1 months following the surgical …