20Shoulder Care
AC Joint Injuries
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Trochanteric Bursa Debridement
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”


The pectoralis major muscle is located on the front of the chest. The pectoralis major originates from two heads: the clavicular (collarbone) and the sternal (breastbone) heads. The two heads unite to form a tendon, and the tendon inserts on the humerus bone below the shoulder joint. The pectoralis plays an important role in internal rotation (rotating the shoulder toward the body) and adduction (bringing the arm toward the body). A tear of the pectoralis major usually occurs during weight-lifting with the shoulder in an externally rotated or extended position. A common exercise associated with pectoralis major tears is the bench press. A tear of the pectoralis major leads to swelling, bruising, pain, and weakness. A tear of the pectoralis major can cause significant weakness and cosmetic deformity, and Dr. Keller may recommend surgery for some patients

During surgery, Dr. Keller makes an incision on the front of the shoulder and then identifies the torn tendon. Dr. Keller then locates the area on the humerus bone where the tendon tore. Dr. Keller then inserts two or three suture anchors (medical screws with sutures) or a “cortical button” into the humerus bone and passes the sutures through the torn tendon. Dr. Keller then tensions the torn pectoralis tendon back down to the humerus and ties strong knots.

Post-Operative Rehabilitation

Following surgery, patients are placed in a sling for comfort. The arm is positioned in a neutral or internally-rotated position. This position keeps tension off of the repaired tissue. Dr. Keller recommends intermittent icing and gentle range of motion following surgery. Dr. Keller also recommends starting physical therapy 2-4 weeks after surgery. Physical therapy focuses on reducing swelling in the shoulder, restoring range of motion, and eventually, restoring strength to the shoulder. It is very important to follow the rehabilitation process carefully to achieve the best outcome.