Complete Avulsion of the Proximal Hamstring Insertion: Functional Outcomes After Nonsurgical Treatment

Abstract

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Complete proximal hamstring avulsions: is there a role for conservative management? A systematic review of acute repairs and non-operative management

“…Most studies were either retrospective case series or retrospective case reports; two retrospective reviews of prospectively collected case series were identified 24 25. Of the 22 studies, 17 studies2–4 10 11 13 14 16–18 20–25 reported on return to sport and of the 22 studies, 13 studies1–3 11–13 15 17–19 22 24 26 reported on patient satisfaction with 10 studies2 3 11–13 17–19 22 24 reporting on both outcomes. Four studies3 10 11 22 identified non-operative management of acute hamstring avulsions and 181 2 4 12–26 studies identified operative management of acute hamstring injuries, with 1 study22 detailing operative and non-operative management.…”

“…We identified only four studies3 10 11 22 that detailed a total of 24 patients who underwent non-operative management of complete, proximal hamstring ruptures. Of these four studies, follow-up ranged from 31 months to 7 years with 1 study not reporting follow-up.…”

“…Two patients reported later operative management secondary to dissatisfaction with non-operative management. Three studies3 10 22 reported on functional strength deficit and values ranged from 60 to 80% decreased strength of the injured hamstring complex when compared to the contralateral side.…”

Beckennahe Sehnenverletzungen

“…Die mittlere Retraktion der HamstringSehnen liegt bei 7 cm (0-20 cm) [6] In einer retrospektiven Serie von 19 Patienten zeigte die konservative Therapie von kompletten proximalen Avulsionsverletzungen eine Muskelkraft von 66 % bei Knieflexion von 90°im Vergleich zur gesunden Seite nach durchschnittlich 31 Monaten [7]. 70,5 % erreichten wieder das vorhergehende sportliche Aktivitäts-level.…”

What’s New in Sports Medicine

“…Proximal hamstring tears typically occur in more active populations and create treatment dilemmas. A Level-IV study evaluated the outcomes of nineteen patients (mean age, fiftynine years) with complete proximal hamstring avulsions treated conservatively 73 . The authors determined that nonsurgical treatment yielded notable subjective outcome and strength deficits at a mean of thirty-one months postoperatively.…”