ReviewJSES reviews, reports, and techniques2026
Pectoralis major transfer over vs. under the conjoint tendon for the treatment of irreparable subscapularis rupture: a systematic review comparing clinical outcomes, complications, and failure rates.
Review in JSES reviews, reports, and techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
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Abstract
Background: Transfer of the pectoralis major muscle tendon unit has proven to be an effective solution for reconstituting the force couple after rotator cuff tears involving an irreparable subscapularis tendon. The tendon can be routed over or under the conjoint tendon; however, it is unclear if tendon routing influences postoperative outcomes. The purpose of this study was to compare the complication rates and clinical outcome measures between pectoralis major transfer performed with a subcoracoid vs. supracoracoid tendon routing. Methods: We performed a systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, querying MEDLINE (PubMed) and EMBASE databases for studies reporting outcomes and complications following pectoralis major transfer with a minimum of 1-year follow-up. We assessed the methodological quality of each study using the methodological index for nonrandomized studies score and extracted patient demographic, surgical, and outcome data. Results: Seven studies involving 179 shoulders (174 patients) were included. The mean patient age was 57.6 years with a follow-up of 71.5 months. Tendon routing over (n = 76 shoulders) or under (n = 103 shoulders) the conjoint tendon showed similar improvements in Constant Score (+20.4 vs. +28.6, Conclusion: The complication rate, incidence of subsequent surgery, and Constant-Murley Score did not differ based on whether the pectoralis major tendon was placed over or under the conjoint tendon during transfers. However, graft failure rates were greater in cohorts using only the sternocostal head of the pectoralis major tendon, while all other outcomes were similar.
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