2023 ISAKOS Biennial Congress ePoster
Chronic Reconstruction of the Tendon of the Pectoralis Major Muscle with Autologous Fascia Lata Graft. Analyzing Histology and MRI Image. A Prospective Study
Alberto C. Pocchini, São Paulo, SP BRAZIL
Benno Ejnisman, MD, São Paulo, SP BRAZIL
Tieslivi Vieira, MD, São Paulo BRAZIL
Eduardo Bracco Cianciarulo, md BRAZIL
Carlos V. Andreoli, PhD, São Paulo, SP BRAZIL
Leandro MASINI Ribeiro, São Paulo, SP BRAZIL
Paulo Henrique Schmidt Lara, MD, São Paulo, São Paulo BRAZIL
Andre Fukunishi Fukunishi Yamada, PhD, São Paulo, Sao Paulo BRAZIL
Moises Cohen, MD, PhD, Prof., São Paulo, SP BRAZIL
Universidade Federal de São Paulo - UNIFESP, São Paulo, São Paulo, BRAZIL
FDA Status Not Applicable
Summary
EVALUATION OF PATIENTS WITH CHRONIC INJURY OF THE PECTORAL MAJOR TENDON SUBMITTED TO FASCIA LATA AUTOGRAFT REPAIR AS TO HISTOLOGY AND MRI RESULTS
ePosters will be available shortly before Congress
Abstract
Backgroud: Total musculotendinous ruptures usually lead to corresponding muscle atrophy and when treated chronically after months of injury there is doubt as to the ability of the muscle to return to its previous function
Purpose
To study chronic rupture of the pectoralis major muscle in patients by assessing the degree of muscle degeneration using magnetic resonance imaging , optical microscopy and fascia lata autologous graft.
Study Design: Proscpective Cohort Study
Methods
Between 2014 and 2018, a prospective study with 30 male patients who participated in weightlifting were evaluated, among whom 20 (mean age 37.3 years, SD = 9.7 years) had chronic complete PMM rupture from 3 months to 5 years and 10 controls (mean age 32.6 years, SD = 4.2 years) The patients were evaluated preoperatively using a Siemens 1.5 Tesla magnetic resonance imaging (MRI) machine. Patients with chronic PM rupture underwent surgery using fascia lata autologous graft, and 2 PMM fragments were collected 1 cm from the edge of the rupture at sternocostal portion that is always affected in bench press injuries. The fragments were analyzed by a pathologist using hematoxylin and eosin (H&E) staining and analyzed for signs of muscle degeneration in the retracted muscle portion
Results
The images MRI , Regarding the Goutallier classification of the muscle , all muscles of the control participants were classified as grade 0; on the operated side of participants in the case group, 4.5% of the muscles were classified as grade 1, 90.9% were classified as grade 2, and 4.5% were classified as grade 3. In the evaluations of muscle degeneration in the muscle fragments we observed ischemic changes in 33.3% fragments, and no fragments presented with fatty infiltration. Clinically, the 20 patients operated according to Bak's criteria: 10 excellent, 5 good, 4 regular and 1 poor.
Conclusions
Muscle samples obtained from cronic injuries showed no histological signs of muscle degeneration. MRI assessment of chronic PMM ruptures did not reveal significant degenerative changes and PMM reconstruction can be performed in chronic cases.