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. 2022 Sep 6;4(5):e1739-e1746.
doi: 10.1016/j.asmr.2022.06.021. eCollection 2022 Oct.

Clinical Outcomes of Pectoralis Major Tendon Repair with and without Platelet-Rich Plasma

Jared A Hanson  1 , Marilee P Horan  1 , Michael J Foster  1   2 , Kaitlyn E Whitney  1 , Justin J Ernat  1   3 , Dylan R Rakowski  1 , Annalise M Peebles  1 , Johnny Huard  1 , Matthew T Provencher  1   2 , Peter J Millett  1   2
Affiliations

Clinical Outcomes of Pectoralis Major Tendon Repair with and without Platelet-Rich Plasma

Jared A Hanson et al. Arthrosc Sports Med Rehabil. .

Abstract

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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Figures

Fig 1
Fig 1
Intraoperative images of surgical repair of a left pectoralis major tendon avulsed from native humeral insertion site. Site of refixation humeral is demonstrated (A) with properly spaced pectoralis buttons (B) and finally the sternal head of the pectoralis major tendon is shown reattached to the humerus (C). PRP injection is performed to allow PRP to surround the surgical repair (D). (PRP, platelet-rich plasma.)
Fig 2
Fig 2
Flow diagram. (AC, acromioclavicular.)
See this image and copyright information in PMC

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