Pectoralis major tendon rupture repairs using intramedullary suture anchors shows high patient-reported outcomes in military service members

Abstract

BackgroundIn the general population pectoralis major tendon ruptures are uncommon; however, it is a common injury in the military population. The military service members have greater physical demands than the general population. The purpose of this study is to critically assess the post-operative outcomes of pectoralis major tendon ruptures in military service members following a repair using intramedullary suture anchors. PurposeTo report outcomes of pectoralis major repairs utilizing intramedullary suture anchors in military service members. MethodsA retrospective chart review was performed between 2014 to 2022, identifying patients who underwent a pectoralis major rupture repair performed by the senior surgeon using intramedullary suture anchors. Records were reviewed for age, gender, mechanism of injury, chronicity, VAS, and SANE scores. Patients who had less than 1 year of follow-up were excluded from the study. During the study period, 18 patients underwent surgical repair of their torn pectoralis major, and 15 patients were greater than 1-year post-operative. Twelve of these 15 patients (80%) were successfully contacted, and patient reported outcomes were collected. ResultsA total of 12 patients (12 male, 0 female) with a mean age of 34.5 years, were identified. Average time from injury to surgery was 471.4 days. The average duration of follow-up was 3.7 years. There was a decrease in the preoperative average single repetition maximum (1RM) barbell bench press of 277 lbs to a postoperative average 1RM bench press of 225 lbs (p-value=0.03). The average change in average 1RM barbell bench press is a 19.04% decrease postoperatively. Postoperative SANE score was 80.8 and an ASES of 86.9. Seven patients (58.3%) stated that they were afraid to bench press at their previous weight due to fear of reinjury. None of the patients were medically discharged from the military due to limitations from their repaired shoulder. Ten patients (83%) reported that they were extremely satisfied with their shoulder function post-operatively. ConclusionRepair of the pectoralis major tendon ruptures using intramedullary suture anchors has high rates of return to duty, patient satisfaction and patient reported outcomes. Greater than half of the patients reported that they were afraid to bench press at their preinjury weight due to concerns of reinjury; the decrease in post-operative strength may be a result of the patients’ fear of reinjury rather than physiologic limitations.