Background

Pectoralis major tendon tears are uncommon and typically occur during weightlifting or sports such as football and wrestling. Although some tears can be managed via primary repair, reconstruction may be necessary for patients in whom primary fails. Various graft options, such as Achilles tendon allografts, have been used to reconstruct the pectoralis major tendon. These grafts help restore strength, tendon shape, and proper insertion into the humeral footprint.

Purpose

This video demonstrates revision of a failed repair of the pectoralis tendon. The technique involves the use of multiple Achilles tendon allografts for reconstruction. Methods

The evaluation, diagnosis, and management of chronic pectoralis major tendon tears is discussed. The case presentation of a 41-year-old man in whom pectoralis major tendon repair failed and who underwent revision reconstruction with the use of multiple Achilles tendon allografts.

Results

The patient progressed through a standardized rehabilitation protocol. At 3-month follow-up, the patient had restoration of pectoralis major tendon contour; no pain; and full, painless range of motion.

Conclusion

The use of multiple Achilles tendon allografts for surgical reconstruction of the pectoralis major tendon is useful in patients with a chronic tear and patients in whom primary repair fails. This approach aims to restore strength and the natural contour of the tendon. The results from the institution of the authors of this video indicate promising clinical outcomes.