Universität zu Köln

Wahlers, Christopher ORCID: 0000-0001-8901-4780, Hoffeld, Kai ORCID: 0000-0002-0742-0791, Hockmann, Jan ORCID: 0000-0002-6408-1415, Müller, Lars Peter ORCID: 0000-0001-9769-6865, Leschinger, Tim ORCID: 0000-0003-1319-6949 and Hackl, Michael (2025). Pectoralis major tendon tears: a biomechanical study to analyze the influence of intratendinous suture distance on repair stability. Journal of Shoulder and Elbow Surgery, 34 (10). e890-e896. Elsevier. ISSN 1058-2746

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Abstract

Background: Tendon tears of the pectoralis major (PM) are uncommon and can be challenging to manage. The lack of consensus on optimal repair methods for PM tendon tears prompts further investigation. Methods: Twenty four fresh-frozen shoulder specimens were used for this biomechanical in-vitro investigation. After simulating complete tears of the PM at its insertion, repair was performed with 3 suture anchors using a locking whipstitch technique of the PM tendon over a length of 2 (group 2), 4 (group 4), or 6 cm (group 6), 8 specimens per group. Incremental cyclic loading of the specimens was performed from 10 to 200 N and the number of cycles and the force until failure (5-mm gap formation at the tendon-bone interface) occurred were analyzed. Results: The mean number of cycles until failure was 89 for group 2, 81 for group 4, and 175 for group 6. Group 6 withstood significantly more loading cycles than groups 2 and 4 (P = .019). The mean force until failure was 63.8 N for group 2, 67.5 N for group 4, and 110.0 N for group 6. Group 6 reached significantly higher failure loads when compared to groups 2 and 4 (P ≤ .014). Conclusions: This study contributes valuable insights into the optimal suture technique for repair of PM tendon tears, highlighting the biomechanical stability associated with varying lengths of locking whipstitches. The results of this investigation show that a locking whipstitch of the PM tendon over a length of 6 cm provides superior biomechanical properties at time zero. Clinical data are necessary to evaluate its relevance on the functional patient outcome.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Wahlers, Christopher UNSPECIFIED https://orcid.org/0000-0001-8901-4780 UNSPECIFIED Hoffeld, Kai UNSPECIFIED https://orcid.org/0000-0002-0742-0791 UNSPECIFIED Hockmann, Jan UNSPECIFIED https://orcid.org/0000-0002-6408-1415 UNSPECIFIED Müller, Lars Peter UNSPECIFIED https://orcid.org/0000-0001-9769-6865 UNSPECIFIED Leschinger, Tim UNSPECIFIED https://orcid.org/0000-0003-1319-6949 UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-796917
Identification Number:	10.1016/j.jse.2025.01.045
Journal or Publication Title:	Journal of Shoulder and Elbow Surgery
Volume:	34
Number:	10
Page Range:	e890-e896
Number of Pages:	1
Date:	October 2025
Publisher:	Elsevier
ISSN:	1058-2746
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Orthopädie > Klinik und Poliklinik für Orthopädie und Unfallchirurgie
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79691