A prospective evaluation of proximal hamstring tendon avulsions: improved functional outcomes following surgical repair

Blakeney, William G.; Zilko, Simon R; Edmonston, Steven J; Schupp, Natalie E; Annear, Peter

doi:10.1007/s00167-017-4475-0

Cited by 56 publications

(78 citation statements)

References 29 publications

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“…While surgical repair for proximal hamstring ruptures in the acute setting has demonstrated good patient outcomes[5,12], reconstruction for chronic ruptures has been less favourable. In the chronic setting, particularly for patients complaining of significant functional impairment and large tendon defects, late-stage proximal hamstring reconstruction using a free graft harvested from the ipsilateral distal hamstrings demonstrated encouraging clinical outcomes out to 24 months.Albeit a small case series and underpowered to show statistical improvement, the subjective PHAT and SF-12 outcomes at 24 months post-surgery in the current series were similar to that reported previously for acute and chronic proximal hamstring repair[3]. Specifically in the evaluation of surgical reconstruction in the chronic setting using free grafts, Folsom et al[9] reported outcomes in five patients that underwent Achilles allograft reconstruction, and reported encouraging outcomes at final follow up (mean 20 months), albeit without reporting via any validated PROMs.…”

supporting

confidence: 86%

Reconstruction of chronic proximal hamstring avulsion injuries using ipsilateral distal hamstring tendons results in good clinical outcomes and patient satisfaction

Ebert

Gormack

Annear

2018

Knee Surg Sports Traumatol Arthrosc

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confidence: 86%

Reconstruction of chronic proximal hamstring avulsion injuries using ipsilateral distal hamstring tendons results in good clinical outcomes and patient satisfaction

Ebert

Gormack

Annear

2018

Knee Surg Sports Traumatol Arthrosc

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“…In der vorliegenden Studie konnte gezeigt werden, dass die Gesamtergebnisse der Erhebung des PHAT-Scores ähnlich den Ergebnissen der bislang einzig vergleichbaren und zugrundeliegenden Studien von Blakeney et al [7,26] sind. In den dort durchgeführten prospektiven Erhebungen von insgesamt 72 [7] bzw.…”

Section: Diskussionunclassified

“…In den dort durchgeführten prospektiven Erhebungen von insgesamt 72 [7] bzw. 96 Patienten [26] ergab sich z. B. ein mittlerer PHAT-Score von 76,7 Pkt.…”

Section: Diskussionunclassified

“…; SD: ± 21,1). Legt man unseren vergleichbaren Ergebnissen den von Blakeney et al (7,26) in ihren prospektiven Studien beschriebenen jeweiligen Anstieg des PHAT-Scores nach einer operativen Versorgung um 36,4 Pkt. [7] bzw.…”

Section: Diskussionunclassified

“…34,7 Pkt. [26] zugrunde, so lassen auch unsere Ergebnisse vermuten, dass eine operative Versorgung bei komplettem Abriss des proximalen Hamstringkomplexes eine deutliche Verbesserung der subjektiven beschriebenen Funktion erwarten lässt.…”

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Operative Refixation bei proximalem Hamstringabriss: Ist der OP-Zeitpunkt relevant für das funktionelle Outcome?

Best¹,

Eberle²,

Beck³

et al. 2017

Sportverletz Sportschaden

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Proximal hamstring tendon avulsion injuries are rare. If they do occur, surgical treatment with tendon refixation is regarded as the method of choice. Surgical outcome measurements have been investigated heterogeneously and, therefore, are difficult to compare. Hence, the possibility for correlations between postoperative outcomes and surgical methods or time of surgery is limited. Using the new, validated and injury-specific Perth Hamstring Assessment Tool (PHAT), we aimed to investigate a population of own patients in order to compare the results in relation to the time of surgery after trauma. In this retrospective case control study, all patients who had undergone hamstring avulsion surgery between 1/2011 and 3/2016 with a follow-up period of at least six months were asked to document their subjective functional outcome using the PHAT. Depending on the time of surgery after trauma, patients and the results of their questionnaires were assigned either to an acute (< 4 weeks), a delayed (1 - 3 months) or a chronic (> 3 months) group. In the named period, 64 patients had a hamstring refixation surgery, 57 of them could be included in the study. 39 (68 %) returned the completed PHAT questionnaire. The mean PHAT score (0 - 100 pts.) was 72.4 (SD ± 21.0). There was no significant difference between the acute and the delayed group (77.0 ± 22.0 vs. 63.4 ± 16.2; p: 0.0673), whereas a significant difference was detected between the acute and the chronic group (77.0 ± 22.0 vs. 58.3 ± 20.2; p: 0.0214). The results of this study show that an early diagnosis and subsequent operation of a hamstring tendon avulsion injury leads to significant better functional outcomes compared with chronic procedures.

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The anatomy of the perineal branch of the sciatic nerve

et al. 2018

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A "perineal" branch of the sciatic nerve has been visualized during surgery, but there is currently no description of this nerve branch in the literature. Our study investigates the presence and frequency of occurrence of perineal innervation by the sciatic nerve and characterizes its anatomy in the posterior thigh. Fifteen cadavers were obtained for dissection. Descriptive results were recorded and analyzed statistically. Twenty-one sciatic nerves were adequately anatomically preserved. Six sciatic nerves contained a perineal branch. Five sciatic nerves had a branch contributing to the perineal branch of the posterior femoral cutaneous (PFC) nerve. In specimens with adequate anatomical preservation, the perineal branch of the sciatic nerve passed posterior to the ischial tuberosity in three specimens and posterior to the conjoint tendon of the long head of biceps femoris and semitendinosus muscles (conjoint tendon) in one. In specimens in which the perineal branch of the PFC nerve received a contribution from the sciatic nerve, the branch passed posterior to the sacrotuberous ligament in one case and posterior to the conjoint tendon in three. Unilateral nerve anatomy was found to be a poor predictor of contralateral anatomy (Cohen's kappa = 0.06). Our study demonstrates for the first time the presence and frequency of occurrence of the perineal branch of the sciatic nerve and a sciatic contribution to the perineal branch of the PFC nerve. Clinicians should be cognizant of this nerve and its varying anatomy so their practice is better informed. Clin. Anat. 31:357-363, 2018. © 2018 Wiley Periodicals, Inc.

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A prospective evaluation of proximal hamstring tendon avulsions: improved functional outcomes following surgical repair

Abstract: II.

Cited by 56 publications

References 29 publications

Reconstruction of chronic proximal hamstring avulsion injuries using ipsilateral distal hamstring tendons results in good clinical outcomes and patient satisfaction

Reconstruction of chronic proximal hamstring avulsion injuries using ipsilateral distal hamstring tendons results in good clinical outcomes and patient satisfaction

Operative Refixation bei proximalem Hamstringabriss: Ist der OP-Zeitpunkt relevant für das funktionelle Outcome?

The anatomy of the perineal branch of the sciatic nerve

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