Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
Aims: Avulsion of the proximal hamstring tendon origin can result in significant functional impairment, with surgical re-attachment of the tendons becoming an increasingly recognized treatment. The aim of this study was to assess the outcomes of surgical management of proximal hamstring tendon avuls...
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2022-05-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.35.BJO-2021-0196.R1 |
| _version_ | 1818518953518956544 |
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| author | Ryan Hillier-Smith Bruce Paton |
| author_facet | Ryan Hillier-Smith Bruce Paton |
| author_sort | Ryan Hillier-Smith |
| collection | DOAJ |
| description | Aims: Avulsion of the proximal hamstring tendon origin can result in significant functional impairment, with surgical re-attachment of the tendons becoming an increasingly recognized treatment. The aim of this study was to assess the outcomes of surgical management of proximal hamstring tendon avulsions, and to compare the results between acute and chronic repairs, as well as between partial and complete injuries. Methods: PubMed, CINAHL, SPORTdiscuss, Cochrane Library, EMBASE, and Web of Science were searched. Studies were screened and quality assessed. Results: In all, 35 studies (1,530 surgically-repaired hamstrings) were included. Mean age at time of repair was 44.7 years (12 to 78). A total of 846 tears were acute, and 684 were chronic, with 520 tears being defined as partial, and 916 as complete. Overall, 92.6% of patients were satisfied with the outcome of their surgery. Mean Lower Extremity Functional Score was 74.7, and was significantly higher in the partial injury group. Mean postoperative hamstring strength was 87.0% of the uninjured limb, and was higher in the partial group. The return to sport (RTS) rate was 84.5%, averaging at a return of 6.5 months. RTS was quicker in the acute group. Re-rupture rate was 1.2% overall, and was lower in the acute group. Sciatic nerve dysfunction rate was 3.5% overall, and lower in the acute group (p < 0.05 in all cases). Conclusion: Surgical treatment results in high satisfaction rates, with good functional outcomes, restoration of muscle strength, and RTS. Partial injuries could expect a higher functional outcome and muscle strength return. Acute repairs result in a quicker RTS with a reduced rate of re-rupture and sciatic nerve dysfunction. Cite this article: Bone Jt Open 2022;3(5):415–422. |
| first_indexed | 2024-12-11T01:17:18Z |
| format | Article |
| id | doaj.art-08b1aa523d6b4de9ab07444002d1cf30 |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-12-11T01:17:18Z |
| publishDate | 2022-05-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-08b1aa523d6b4de9ab07444002d1cf302022-12-22T01:25:50ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622022-05-013541542210.1302/2633-1462.35.BJO-2021-0196.R1Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysisRyan Hillier-Smith0Bruce Paton1University Hospital, Southampton, UKInstitute of Sport Exercise and Health, University Colleage London, University College London Hospitals NHS Foundation Trust, London, UKAims: Avulsion of the proximal hamstring tendon origin can result in significant functional impairment, with surgical re-attachment of the tendons becoming an increasingly recognized treatment. The aim of this study was to assess the outcomes of surgical management of proximal hamstring tendon avulsions, and to compare the results between acute and chronic repairs, as well as between partial and complete injuries. Methods: PubMed, CINAHL, SPORTdiscuss, Cochrane Library, EMBASE, and Web of Science were searched. Studies were screened and quality assessed. Results: In all, 35 studies (1,530 surgically-repaired hamstrings) were included. Mean age at time of repair was 44.7 years (12 to 78). A total of 846 tears were acute, and 684 were chronic, with 520 tears being defined as partial, and 916 as complete. Overall, 92.6% of patients were satisfied with the outcome of their surgery. Mean Lower Extremity Functional Score was 74.7, and was significantly higher in the partial injury group. Mean postoperative hamstring strength was 87.0% of the uninjured limb, and was higher in the partial group. The return to sport (RTS) rate was 84.5%, averaging at a return of 6.5 months. RTS was quicker in the acute group. Re-rupture rate was 1.2% overall, and was lower in the acute group. Sciatic nerve dysfunction rate was 3.5% overall, and lower in the acute group (p < 0.05 in all cases). Conclusion: Surgical treatment results in high satisfaction rates, with good functional outcomes, restoration of muscle strength, and RTS. Partial injuries could expect a higher functional outcome and muscle strength return. Acute repairs result in a quicker RTS with a reduced rate of re-rupture and sciatic nerve dysfunction. Cite this article: Bone Jt Open 2022;3(5):415–422.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.35.BJO-2021-0196.R1hamstringsurgeryhamstring tendonhamstring musclere-rupturesfunctional outcomes scoressciatic nervemuscle strengthtendonshamstring strengthcinahlfunctional score |
| spellingShingle | Ryan Hillier-Smith Bruce Paton Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis Bone & Joint Open hamstring surgery hamstring tendon hamstring muscle re-ruptures functional outcomes scores sciatic nerve muscle strength tendons hamstring strength cinahl functional score |
| title | Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis |
| title_full | Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis |
| title_fullStr | Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis |
| title_full_unstemmed | Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis |
| title_short | Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis |
| title_sort | outcomes following surgical management of proximal hamstring tendon avulsions a systematic review and meta analysis |
| topic | hamstring surgery hamstring tendon hamstring muscle re-ruptures functional outcomes scores sciatic nerve muscle strength tendons hamstring strength cinahl functional score |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.35.BJO-2021-0196.R1 |
| work_keys_str_mv | AT ryanhilliersmith outcomesfollowingsurgicalmanagementofproximalhamstringtendonavulsionsasystematicreviewandmetaanalysis AT brucepaton outcomesfollowingsurgicalmanagementofproximalhamstringtendonavulsionsasystematicreviewandmetaanalysis |