scholarly journals Pectoralis Major Tendon Reconstruction at the Myotendinous Junction With Semitendinosus Allograft: An Operative Technique

2021 ◽  
Vol 1 (2) ◽  
pp. 263502542199713
Author(s):  
John Wickman ◽  
Daniel Goltz ◽  
Brian Lau
Keyword(s):  
Clinical Outcomes ◽  
Pectoralis Major ◽  
Myotendinous Junction ◽  
Recreational Sports ◽  
Musculotendinous Junction ◽  
Muscle Belly ◽  
Tendon Reconstruction ◽  
Active Population ◽  
Active Patients ◽  
Deltopectoral Approach

Background: Pectoralis major (PM) tendon tears are a relatively uncommon injury that typically occurs in a young, active population during weightlifting or recreational sports. Musculotendinous junction and chronic PM tears often require tendon reconstruction due to inadequate remnant tendon stump or inability to reduce the remnant tendon stump to humeral footprint. Indications: We favor operative repair or reconstruction of PM tears in all young and active patients medically appropriate for surgery as supported by the literature. We present a technique for PM tendon reconstruction with semitendinosus allograft. This technique is applicable to musculotendinous junction and chronic tears. Technique: A modified deltopectoral approach is used. The PM tear is identified at the musculotendinous junction and the retracted muscle belly is mobilized. The PM tendon is reconstructed with a semitendinosus allograft using a Pulvertaft weave technique. The humeral footprint is prepped and the reconstructed tendon is properly tensioned and reduced. Fixation is performed with fibertapes loaded on 3 unicortical buttons. Postoperatively, the patient follows a graduated rehabilitation protocol. Results: There is a paucity of literature regarding outcomes of PM tendon reconstructions for musculotendinous junction tears. One study reported outcomes on 6 patients who had musculotendinous junction tears and underwent semitendinosus allograft reconstruction with a technique similar to ours. They report good clinical outcomes with high patient satisfaction regarding cosmetic outcome, return of strength, and overall satisfaction postoperatively. Discussion: It is our experience that the described technique for reconstruction of the PM tendon with semitendinosus allograft provides a viable option with good clinical outcomes for patients with PM ruptures at the musculotendinous junction.

scholarly journals Pectoralis major tendon reconstruction using semitendinosus allograft following rupture at the musculotendinous junction

2019 ◽  
Vol 3 (4) ◽  
pp. 328-332
Author(s):  
Mitchell Long ◽  
Tyler Enders ◽  
Robert Trasolini ◽  
William Schneider ◽  
Anthony Cappellino ◽  
...  
Keyword(s):  
Pectoralis Major ◽  
Musculotendinous Junction ◽  
Tendon Reconstruction

Pectoralis Major Muscle Belly Repair in a Young Male Adult

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michael J. DeRogatis ◽  
Sean C. Kelly ◽  
Andrew M. Hanflik ◽  
Robert Pae ◽  
Elizabeth M. Sieczka ◽  
...  
Keyword(s):  
Pectoralis Major Muscle ◽  
Young Male ◽  
Pectoralis Major ◽  
Male Adult ◽  
Muscle Belly ◽  
Young Male Adult

Effect of Anterior Anchor on Clinical Outcomes of Type II SLAP Repairs in an Active Population

Orthopedics ◽  
2018 ◽  
Vol 42 (1) ◽  
pp. e32-e38 ◽  
Author(s):  
William Arroyo ◽  
Jennifer Misenhimer ◽  
Eric J. Cotter ◽  
Kevin C. Wang ◽  
Kenneth Heida ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Type Ii ◽  
Active Population

scholarly journals 2315. The Relationship of Pre-Hospital Functional Status and Clinical Outcomes in Patients with Laboratory-Confirmed RSV Infection: Active Population-Based Surveillance, 2017–2019

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S794-S794
Author(s):  
Angela Branche ◽  
Lisa Saiman ◽  
Edward E Walsh ◽  
Ann R Falsey ◽  
William Sieling ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Functional Status ◽  
Clinical Outcomes ◽  
Demographic Data ◽  
Patient Characteristics ◽  
Population Based ◽  
Active Population ◽  
Rsv Infection ◽  
Relationship Of ◽  
The Relationship

Abstract Background Respiratory syncytial virus (RSV) infection is a common cause of acute respiratory infection (ARI) in adults. Prospective surveillance enables collection of representative data on demographic and clinical characteristics. Few data of this kind are available for adults hospitalized with RSV infection. We used active population-based surveillance to identify patients with laboratory-confirmed RSV infection and evaluated demographic characteristics and clinical outcomes. Methods Hospitalized adults ≥ 18 years old residing in a predefined catchment area with ≥ 2 ARI symptoms or exacerbation of underlying cardiopulmonary disease were screened for eligibility during October 2017–April 2018 and October 2018–April 2019 in 3 hospitals in Rochester, NY and New York City. Respiratory specimens were tested for RSV using PCR assays. Clinical and demographic data were abstracted from the medical record. Multivariate analysis was used to evaluate the relationship of patient characteristics with clinical outcomes. Results 8,217 hospitalized adults were screened and 9.4% positive for RSV infection. Preliminary clinical and demographic data were available for 348 patients including 14% 18–49 years, 28% 50–64 years and 58% > 65 years. Mean age was 68 years and 60% were female (Figure 1). Patients had a mean of 3 co-morbidities, with diabetes (40%), chronic obstructive pulmonary disease (30%), chronic kidney disease (28%), congestive heart failure (28%), coronary artery disease (25%) and asthma (24%) the most common co-morbidities (Figure 2). Median hospital length of stay was 6 days (IQR 4–10), 13% of patients were admitted to the ICU, 5% were mechanically ventilated and 5% died during admission and 12% within 6 months. In multivariate analysis having > 3 comorbidities, cardiac disease or a lower baseline functional status measured by activities of daily living scores was significantly associated with 6-month mortality. Conclusion The majority of hospitalized patients with RSV infection were older adults with ≥ 3 chronic comorbid conditions. Baseline functional status may be predictive of worse clinical outcomes in patients with RSV infection. These insights into patient characteristics and clinical outcomes will provide information for prevention programs. Disclosures All authors: No reported disclosures.

scholarly journals Anatomical Feasibility Study of Flexor Hallucis Longus Transfer in Treatment of Achilles Tendon and Posterior Ankle Arthroscopy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Haijiao Mao
Keyword(s):  
Achilles Tendon ◽  
Magnetic Resonance Images ◽  
Neurovascular Bundle ◽  
Flexor Hallucis Longus ◽  
Muscle Morphology ◽  
Musculotendinous Junction ◽  
Muscle Belly ◽  
Lateral Muscle ◽  
Significant Difference ◽  
The Relationship

Category: Hindfoot Introduction/Purpose: The aim of this study was to evaluate the occurrence of anatomical variations of the musculotendinous junction of the flexor hallucis longus (FHL) muscle, the relationship between FHL tendon or muscle and the tibial neurovascular bundle at the level of the posterior ankle joint in human cadavers. Methods: Seventy embalmed feet from 20 male and 15female cadavers, the cadavers’ mean age was 65.4 (range from 14 to 82) years, were dissected and anatomically classified to observe FHL muscle morphology define the relationship between FHL tendon or muscle and the tibial neurovascular bundle . The distance between the musculotendinous junction and thehe relationship between FHL tendon or muscle and the tibial neurovascular bundle was determined. Results: The three morphology types of FHL muscle were identified: a long lateral and shorter medial muscle belly, which was observed in 63 specimens (90%).; equal length medial and lateral muscle bellies, this variant was only observed in 5 specimens (7.1%); a lateral and no medial muscle belly, which was observed in 2 specimens (2.9%). No statistically significant difference was observed according to gender or side (p > 0.05). Two patterns were identified and described between FHL tendon or muscle and the tibial neurovascular bundle. Pattern 1, the distance between the neurovascular bundle and FHL tendon was 3.46 mm (range, 2.34 to 8.84, SD = 2.12) which was observed in 66 specimens (94.3%); Pattern 2, there was no distance which was observed in 4 specimens (5.7%). Conclusion: Knowing FHL muscle morphology variations provide new important insights into secure planning and execution of a FHL transfer for Achilles tendon defect as well as for the interpretation of ultrasound and magnetic resonance images. During posterior arthroscopic, posteriormedial portal may be introduced into the posterior aspect of the ankle without gross injury to the tibial neurovascular structures.

scholarly journals Outcomes After Dermal Allograft Reconstruction of Chronic or Subacute Pectoralis Major Tendon Ruptures

2018 ◽  
Vol 6 (1) ◽  
pp. 232596711774583 ◽  
Author(s):  
Julie A. Neumann ◽  
Christopher M. Klein ◽  
Carola F. van Eck ◽  
Hithem Rahmi ◽  
John M. Itamura
Keyword(s):  
External Rotation ◽  
Constant Score ◽  
Case Series ◽  
Pectoralis Major ◽  
Tissue Quality ◽  
Level Of Evidence ◽  
Allograft Reconstruction ◽  
Tendon Reconstruction ◽  
Number Of Patients ◽  
Patient Reported

Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome. Study Design: Case series; Level of evidence, 4. Methods: Nineteen consecutive patients (19 PM ruptures) with a mean ± SD age of 39.1 ± 8.4 years were retrospectively reviewed at 26.4 ± 16.0 months following PM tendon reconstruction with dermal allograft. Surgery was performed at 19.2 ± 41.2 months after injury (median, 7.6 months; range, 1.1-185.4 months). Several outcome scores were recorded pre- and postoperatively, including Disabilities of the Arm, Shoulder, and Hand (DASH), as well as visual analog scale (VAS) (range, 0-10; 0 = no pain) and Single Assessment Numeric Evaluation (SANE). Range of motion, Constant score, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test score, and complications/reoperations were recorded postoperatively. Results: Scores improved significantly for the DASH (preoperative, 34.9; postoperative, 8.0; P < .001) and VAS (preoperative, 5.0; postoperative, 1.5; P = .011). There was a trend toward improved SANE scores (preoperative, 15.0; postoperative, 80.0; P = .097), but the difference was not statistically significant, likely because of the small number of patients having preoperative SANE scores for review. Increased age was associated with higher VAS scores ( r = 0.628, P = .016) and less forward flexion ( r = –0.502, P = .048) and external rotation ( r = –0.654, P = .006). Patients with workers’ compensation had lower scores for 3 measures: SANE (75.8 vs 88.4, P = .040), Constant (86.7 vs 93.4, P = .019), and ASES (81.9 vs 97.4, P = .016). Operating on the dominant extremity resulted in lower Constant scores (87.8 vs 95.4, P = .012). A 2-head tendon tear (107.5° vs 123.3°, P = .033) and the use of >1 graft (105.0° vs 121.3°, P = .040) resulted in decreased abduction. Conclusion: This was the first large series to observe patients with chronic or subacute PM tendon tears treated with dermal allograft reconstruction. PM tendon reconstruction with dermal allografts resulted in good objective and subjective patient-reported outcomes.

scholarly journals Endoscopic shelf acetabuloplasty can improve clinical outcomes and achieve return to sports-related activity in active patients with hip dysplasia

2017 ◽  
Vol 26 (10) ◽  
pp. 3165-3177 ◽  
Author(s):  
Soshi Uchida ◽  
Akihisa Hatakeyama ◽  
Shiho Kanezaki ◽  
Hajime Utsunomiya ◽  
Hitoshi Suzuki ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Hip Dysplasia ◽  
Return To Sports ◽  
Related Activity ◽  
Shelf Acetabuloplasty ◽  
Active Patients

scholarly journals Subscapular and Pectoralis Major Sparing Deltopectoral Approach for Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 22 (2) ◽  
pp. 110-112 ◽  
Author(s):  
Young-Woo Chung ◽  
Jae-Woong Seo ◽  
Ki-Yong An
Keyword(s):  
Total Shoulder Arthroplasty ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Subscapularis Tendon ◽  
Shoulder Replacement ◽  
Lesser Tuberosity ◽  
Replacement Surgery ◽  
Subscapularis Muscle ◽  
Reverse Total Shoulder ◽  
Deltopectoral Approach

In reverse ball shoulder replacement, surgery is usually performed using a deltopectoral approach or an anterosuperior transdeltoid approach. The deltopectoral approach is to incise the pectoralis major to upper 1/3 to 1/2, and subscapularis tendon should be removed at the lesser tuberosity of the humerus. This approach has the problem of breaking the shoulder deltoid instead of incising the rotator cuff. Therefore, we report a detailed procedure of reverse ball shoulder replacement using approach without incision of the pectoralis major muscle and subscapularis muscle.

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