Summary

Pectoralis major tendon repair results in 95% return to activity with the majority of individuals reporting pain relief and improved cosmetic appearance.

Abstract

Background

Pectoralis major tendon ruptures are becoming increasingly common due to the growing prevalence of active lifestyles. The purpose of this systematic review is to determine the outcomes and rate of return to activity after isolated pectoralis major tendon repair.

Methods

A search of PubMed, Embase, Medline, CINAHL databases was performed for all articles evaluating the return to activity after pectoralis major tendon repair. Two reviewers independently screened all titles, abstracts, and full-texts for eligibility. A methodological quality assessment was completed for all included studies.

Results

From 2332 articles, 18 case series with a total of 536 patients were included. 90% (134/149) of patients undergoing pectoralis major tendon repair successfully returned to sport, of which 74% (95/128) successfully returned to their preinjury level of sport. The mean reported time for unrestricted return to sport after pectoralis major tendon repair was 6 ± 1.7 months. 95% (269/284) of patients returned to work, at a mean time of 6.9 ± 0.9 months. 81% (83/102) of patients experienced complete pain relief after the surgery and 19% (21/109) had cosmetic complaints following pectoralis major repair. The most common reported causes of pectoralis major tendon rupture were bench press (n=300) and contact sports (n=49). Of the 10 studies that reported complications, 18% (75/423) of patients had postoperative complications including re-ruptures and wound infections. 7% (30/423) of patients required reoperation for their complications.

Conclusions

Current available evidence suggests that pectoralis major tendon repair results in 90% return to sport, and 95% return to work, with most patients reporting pain relief and improved cosmetic appearance. Complications were reported in 18% of patients, with reoperation in 7% of patients. The evidence supporting all outcomes were limited by the rarity of the injury, the variable surgical techniques, rehabilitation protocols, and outcome assessment criteria.

Level of Evidence:
Level IV, systematic review of Level IV studies.