No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis
Abstract Purpose Surgical options for pectoralis major tendon tears include primary repair, though there is no consensus as to which constructs are biomechanically superior for repair. Methods A systematic review was performed by searching PubMed, the Cochrane library, and Embase using PRISMA guidel...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-023-00617-9 |
| _version_ | 1797270786741895168 |
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| author | Sean B. Sequeira Lynette M. Sequeira Mark D. Wieland Casey M. Imbergamo Kenneth Tepper |
| author_facet | Sean B. Sequeira Lynette M. Sequeira Mark D. Wieland Casey M. Imbergamo Kenneth Tepper |
| author_sort | Sean B. Sequeira |
| collection | DOAJ |
| description | Abstract Purpose Surgical options for pectoralis major tendon tears include primary repair, though there is no consensus as to which constructs are biomechanically superior for repair. Methods A systematic review was performed by searching PubMed, the Cochrane library, and Embase using PRISMA guidelines to identify studies that analyzed the biomechanical properties of bone tunnels (BT), cortical buttons (CB) and suture anchors (SA) techniques for pectoralis major tendon repair. The search phrase implemented was ‘pectoralis major tendon repair biomechanics’. Studies that did not evaluate biomechanical outcome data, evaluated partial pectoralis major tendon tears, and non‐English articles were excluded. Evaluated outcomes included ultimate load to failure (N) and stiffness (N/mm). Results Six studies met inclusion criteria, including a total of 124 cadaveric specimens, for pectoralis major tendon repair comparing BT with SA and CB. Pooled analysis from four studies reporting on ultimate load to failure between BT and SA failed to reveal a difference between BT and SA (p = 0.489). Pooled analysis from two studies reporting on stiffness failed to reveal a difference in favor of BT compared to SA (p = 0.705). Pooled analysis from four studies reporting on ultimate load to failure between BT and CB failed to reveal a difference between BT and CB (p = 0.567). Pooled analysis from two studies reporting on stiffness failed to reveal a difference in favor of BT compared to CB (p = 0.701). Conclusions There was no difference in load to failure or stiffness when using BT, CB, or SA in pectoralis major tendon repairs. This review reveals that clinical outcomes may better inform which fixation construct to implement in pectoralis major tendon repairs. Level of evidence I. |
| first_indexed | 2024-03-08T04:57:38Z |
| format | Article |
| id | doaj.art-9b052ef122ca498fbefda0971abf37bd |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-04-25T02:09:48Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-9b052ef122ca498fbefda0971abf37bd2024-03-07T12:46:41ZengWileyJournal of Experimental Orthopaedics2197-11532023-01-01101n/an/a10.1186/s40634-023-00617-9No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysisSean B. Sequeira0Lynette M. Sequeira1Mark D. Wieland2Casey M. Imbergamo3Kenneth Tepper4Department of Orthopaedic SurgeryMedStar Union Memorial Hospital3333 North Calvert, Street, Suite 40021218BaltimoreMDUSADepartment of Orthopaedic SurgeryMedStar Union Memorial Hospital3333 North Calvert, Street, Suite 40021218BaltimoreMDUSADepartment of Orthopaedic SurgeryMedStar Union Memorial Hospital3333 North Calvert, Street, Suite 40021218BaltimoreMDUSADepartment of Orthopaedic SurgeryMedStar Union Memorial Hospital3333 North Calvert, Street, Suite 40021218BaltimoreMDUSADepartment of Orthopaedic SurgeryMedStar Union Memorial Hospital3333 North Calvert, Street, Suite 40021218BaltimoreMDUSAAbstract Purpose Surgical options for pectoralis major tendon tears include primary repair, though there is no consensus as to which constructs are biomechanically superior for repair. Methods A systematic review was performed by searching PubMed, the Cochrane library, and Embase using PRISMA guidelines to identify studies that analyzed the biomechanical properties of bone tunnels (BT), cortical buttons (CB) and suture anchors (SA) techniques for pectoralis major tendon repair. The search phrase implemented was ‘pectoralis major tendon repair biomechanics’. Studies that did not evaluate biomechanical outcome data, evaluated partial pectoralis major tendon tears, and non‐English articles were excluded. Evaluated outcomes included ultimate load to failure (N) and stiffness (N/mm). Results Six studies met inclusion criteria, including a total of 124 cadaveric specimens, for pectoralis major tendon repair comparing BT with SA and CB. Pooled analysis from four studies reporting on ultimate load to failure between BT and SA failed to reveal a difference between BT and SA (p = 0.489). Pooled analysis from two studies reporting on stiffness failed to reveal a difference in favor of BT compared to SA (p = 0.705). Pooled analysis from four studies reporting on ultimate load to failure between BT and CB failed to reveal a difference between BT and CB (p = 0.567). Pooled analysis from two studies reporting on stiffness failed to reveal a difference in favor of BT compared to CB (p = 0.701). Conclusions There was no difference in load to failure or stiffness when using BT, CB, or SA in pectoralis major tendon repairs. This review reveals that clinical outcomes may better inform which fixation construct to implement in pectoralis major tendon repairs. Level of evidence I.https://doi.org/10.1186/s40634-023-00617-9Pectoralis major tendon repairBone troughSuture anchorBiomechanicsCadaveric studies |
| spellingShingle | Sean B. Sequeira Lynette M. Sequeira Mark D. Wieland Casey M. Imbergamo Kenneth Tepper No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis Journal of Experimental Orthopaedics Pectoralis major tendon repair Bone trough Suture anchor Biomechanics Cadaveric studies |
| title | No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis |
| title_full | No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis |
| title_fullStr | No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis |
| title_full_unstemmed | No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis |
| title_short | No difference in load to failure or stiffness between transosseous tunnels, suture anchors, and cortical buttons for pectoralis major tendon repair: a systematic review & meta‐analysis |
| title_sort | no difference in load to failure or stiffness between transosseous tunnels suture anchors and cortical buttons for pectoralis major tendon repair a systematic review meta analysis |
| topic | Pectoralis major tendon repair Bone trough Suture anchor Biomechanics Cadaveric studies |
| url | https://doi.org/10.1186/s40634-023-00617-9 |
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