Pectoralis major rupture repair with Achilles tendon allograft in 22 bodybuilding athletes

Background: Pectoralis major tendon rupture rate is increasing due to increased tendency to bodybuilding exercises, specially the bench press workout, and weight-lifting. The aim of this study was to determine the results of pectoralis major rupture repair with Achilles tendon allograft in bodybuilding athletes.Methods: In this case series study, 22 bodybuilding athlete patients (24 pectoralis major ruptures) were undergone open surgical repair during January 2016 till December 2020. 21 ruptures were chronic (2 ruptures were revision) and 3 ruptures were acute. Surgical method was based on Achilles tendon allograft used to augment the ruptured site for lengthening the shortened tendon.The results were analyzed using Bak's criteria and Constant score in pre operation visit and 6th and 12th months and in the last follow up.Results: All cases were male with the mean age of 32.1 +/- 5.4. The mean duration time between injuries to surgery was 37 +/- 46 month (1-182 months). Return to professional sport began at 10.9 +/- 2.8 months after surgery in which 16 cases (66.7%) have returned to their pre surgery bench press workout records. No infection or hematoma occurred. At the final follow-up, Bak criteria demonstrated excellent, good and fair in 4, 18 and 2 shoulders respectively. The constant score increased from 87.9 +/- 7.9 in pre operation visit to 92.7 +/- 6.4 in the last follow up (P < 0.001).Conclusions: It seems that our surgical method is an effective approach in cases with acute or chronic pectoralis major ruptures.