TITLE

Functional Outcome After Repair of Proximal Hamstring Avulsions

AUTHOR(S)
Birmingham, Patrick; Muller, Mark; Wickiewicz, Thomas; Cavanaugh, John; Rodeo, Scott; Warren, Russell
PUB. DATE
October 2011
SOURCE
Journal of Bone & Joint Surgery, American Volume;10/5/2011, Vol. 93-A Issue 19, p1819
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Rupture of the proximal origin of the hamstrings leads to pain, weakness, and a debilitating decrease in physical activity. Repair of these injuries should be based on the expectation that these deficits can be addressed. The goal of this study was to objectively evaluate the efficacy of repair of proximal hamstring avulsions. Methods: Thirty-four patients were identified retrospectively to have a complete rupture of the proximal origin of the hamstrings based on the presence of a bowstring sign and the results of magnetic resonance imaging (MRI). Patients were contacted for follow-up evaluation to fill out a subjective questionnaire, to undergo functional testing, and to undergo isokinetic testing on a Cybex dynamometer. Twenty-three patients were evaluated. Results: There were nine acute and fourteen chronic repairs, and the average period of follow-up was 43.3 months. Twenty-one of twenty-three patients reported returning to activity at an average of 95% of their pre-injury activity level at an average of 9.8 months. Eighteen patients reported excellent results; four, good results; and one, fair results. Hamstring strength was an average of 93% and 90% of that in the uninvolved limb at 2400 per second and 180° per second, respectively. The hamstrings-to-quadriceps ratio was 56% for 240° per second and 48% at 180° per-second. Hamstring endurance was an average of 81% and 91% of the nonoperative limb at 240° per second and 180° per second, respectively. Postoperative quadriceps strength and endurance were positively correlated with return to pre-injury level of activity (r = 0.6, p < 0.05; and r = 0.6, p < 0.05) and negatively correlated with time to return to sport (r = -0.5, p < 0.05; and r = -0.5, p < 0.05). There was no significant effect associated with age or time from injury. Conclusions: Repair of a symptomatic and displaced ruptured proximal hamstring tendon yields good subjective and objective functional results with minimal complications. Overall, patients are satisfied with surgical repair and experience return of functional activity with minimal postoperative weakness.
ACCESSION #
66737112

 

Related Articles

  • Reattachment of the proximal hamstring origin: outcome in patients with partial and complete tears. Barnett, A.; Negus, J.; Barton, T.; Wood, D. // Knee Surgery, Sports Traumatology, Arthroscopy;Jul2015, Vol. 23 Issue 7, p2130 

    Purpose: To assess the subjective and functional outcome in complete and partial injuries, both acute and chronic. Methods: One hundred and thirty-two consecutive proximal hamstring reattachments were performed by a single surgeon between 1999 and 2009. The mean age at the time of operation was...

  • SPECT-CT of an unsuspected ischial tuberosity avulsion fracture. AlHusseini, Rasha; Siraj, Qaisar H. // Pakistan Journal of Nuclear Medicine;Jun2014, Vol. 3 Issue 1, p65 

    Ischial tuberosity avulsion fracture usually occurs between puberty and late adolescence where the ischial tuberosity apophysis remains open and nonossified. Avulsion commonly occurs in young athletes resulting from sudden forcible contraction of the hamstrings during sudden forceful physical...

  • Successful clinical outcomes of proximal hamstring avulsion repair in athletes presenting within 6 weeks, 6 months and after 6 months. Benjamin-Laing, H.; Haddad, F. S. // Muscles, Ligaments & Tendons Journal (MLTJ);2012 Supplement, p14 

    Avulsion of the hamstring origin is well documented in water-skiing, rugby, sprinting and hurdling and is increasingly seen in football, dancing, judo and bull-riding. The purpose of the study was to compare the outcomes of surgical intervention within 6 weeks of injury, 6 months post-injury and...

  • Een laat gediagnosticeerde avulsiefractuur van het tuber ischiadicum bij een adolescent. de Koning, M. T. G.; van Ooij, A.; Eijkelenboom, P. R. // Sport & Geneeskunde;maa2012, Vol. 45 Issue 1, p14 

    Hamstrings injuries are common injuries, especially among athletes. Most of these injuries are treated conservatively. In case of an avulsion of the ischial tuberosity surgery may be indicated if the diagnosis is made early. An undiagnosed fracture may lead tot persistent pain, functional...

  • Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Askling, Carl M.; Tengvar, Magnus; Thorstensson, Alf // British Journal of Sports Medicine;Oct2013, Vol. 47 Issue 15, p953 

    Background Hamstring injury is the single most common injury in European professional football and, therefore, time to return and secondary prevention are of particular concern. Objective To compare the effectiveness of two rehabilitation protocols after acute hamstring injury in Swedish elite...

  • MR observations of long-term musculotendon remodeling following a hamstring strain injury. Amy Silder; Timothy Enright // Skeletal Radiology;Dec2008, Vol. 37 Issue 12, p1101 

    Abstract Objective  The objective of this study was to use magnetic resonance (MR) imaging to investigate long-term changes in muscle and tendon morphology following a hamstring strain injury. Materials and methods  MR images were obtained from 14 athletes who...

  • Two patients with a complete proximal rupture of the hamstring. Floor, Sebastiaan; van der Veen, Alex H.; Devilee, Roger J. // Archives of Orthopaedic & Trauma Surgery;Apr2010, Vol. 130 Issue 4, p523 

    Two men visited our Emergency Room because of a water-ski-accident. At physical examination, there was hematoma at the upper leg with loss of strength at extension of the hip and flexion of the knee. Both patients had a palpable gap just distal of the ischial tuberosity. Further imaging by...

  • Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial. Arumugam, Ashokan // New Zealand Journal of Physiotherapy;Mar2014, Vol. 42 Issue 1, p47 

    Aim To investigate differences between two rehabilitation programmes (progressive running and eccentric training [PRES] and progressive agility and trunk stabilization training [PATS]) on clinical and morphological recovery following acute hamstring injury. Methods A double-blind, randomised...

  • Total proximal hamstring ruptures: clinical and MRI aspects including guidelines for postoperative rehabilitation. Askling, Carl; Koulouris, George; Saartok, Tönu; Werner, Suzanne; Best, Thomas // Knee Surgery, Sports Traumatology, Arthroscopy;Mar2013, Vol. 21 Issue 3, p515 

    The aim of this article is to provide a state-of-the-art review for treatment of acute, total proximal hamstring tendon ruptures. For total proximal hamstring tendon ruptures, early (<2-3 w) surgical refixation minimizes muscle atrophy and facilitates a somewhat predictable time course for...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics