Endoscopic Partial Proximal Hamstring Repair

Capurro, Bruno; Chapman, Reagan; Kaplan, Daniel J.; Larson, Jordan H.; Nho, Shane J.

doi:10.1016/j.eats.2023.02.045

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…The endoscopic operative technique used in this patient cohort has been reported previously. 9,34 Briefly, the patient was placed in a prone position with the endoscopic portals placed along the gluteal crease. Just inside the lateral border of the ischial tuberosity and approximately 2 cm below the lowermost point of the ischium, the first portal was established.…”

Section: Surgical Techniquementioning

confidence: 99%

Association Between Proximal Hamstring Tear Characteristics and Achievement of Clinically Significant Outcomes After Endoscopic and Open Repair at Minimum 2-Year Follow-up

Fenn,

Brusalis,

Allahabadi

et al. 2024

Am J Sports Med

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Background: The effect of preoperative tear characteristics and the relative efficacy of open versus endoscopic surgical techniques have not been elucidated for the surgical treatment of proximal hamstring tendon injuries. Purpose: (1) To report on achievement rates of clinically significant outcomes at a minimum 2-year follow-up for multiple patient-reported outcomes (PROs) after surgical treatment of proximal hamstring injuries, stratified according to severity of proximal hamstring injury, and (2) to compare clinical outcomes associated with endoscopic versus open surgical repair for a subset of similarly classified tears. Study Design: Cohort study; Level of evidence, 3 Methods: A single-surgeon clinical registry was queried for patients who underwent surgical repair for proximal hamstring ruptures between January 2012 and March 2021. Injuries were classified by magnetic resonance imaging as follows: grade 1, incomplete tear with the involvement of 1 or 2 tendons; grade 2, complete tear with the involvement of 3 tendons and ≤2-cm retraction; and grade 3, complete tear with the involvement of 3 tendons and >2-cm retraction. The Patient Acceptable Symptom State (PASS) for multiple PROs was calculated and compared among injury grades and between surgical techniques. Results: Among 75 patients with a mean follow-up of 30.5 ± 5.1 months, 20 had grade 1 tears, 24 had grade 2 tears, and 31 had grade 3 tears. Favorable 2-year postoperative PROs were demonstrated by each grade for all measured PROs. Patients with grade 3 tears were noted to have significantly lower rates of 2-year PASS achievement for the Hip Outcome Score–Activities of Daily Living (HOS-ADL) and Hip Outcome Score–Sports Specific (HOS-SS) scales ( P≤ .032). Among grade 2 tears, patients treated endoscopically demonstrated significantly greater HOS-SS (endoscopic, 91.7%; open, 58.3%; P = .045) and Patient-Reported Outcomes Measurement Information System for Physical Function (endoscopic, 80.0%; open, 50.0%; P = .033) PASS achievement rates compared with those treated with the open technique. Complication rates were highest in patients with grade 3 tears (45.2%, P = .043). Conclusion: Surgical repair of proximal hamstring tendon tears with varying extents of tendon retraction resulted in high rates of achieving PASS at the 2-year follow-up. Among complete tears with <2 cm of retraction, endoscopic repairs exhibited equal or higher rates of achieving PASS compared with open repairs across multiple PROs at 2 years postoperatively. However, patients with complete tears and retraction >2 cm achieved lower rates of PASS on the HOS-ADL and HOS-SS scales and had a higher rate of complications.

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Section: Surgical Techniquementioning

confidence: 99%

Association Between Proximal Hamstring Tear Characteristics and Achievement of Clinically Significant Outcomes After Endoscopic and Open Repair at Minimum 2-Year Follow-up

Fenn,

Brusalis,

Allahabadi

et al. 2024

Am J Sports Med

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Non‐surgical management of acute proximal hamstring avulsions can produce clinically acceptable results

Maffulli,

Hassan,

Poku

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo evaluate the mid‐term clinical outcomes for the non‐surgical and surgical management of acute proximal hamstring avulsions.MethodsSixty physically active individuals were offered surgical or non‐surgical management for their proximal hamstring avulsion injuries. Distal retraction was defined as greater than 2 cm. Primary outcome measures were the Victorian Institute of sport assessment‐proximal hamstring tendons (VISA‐H) and functional assessment scale for acute hamstring injuries (FASH). Secondary outcome measures included palpable gap (cm), return to sport (RTS) and the ability to perform Nordic hamstring curls. Outcome variables were adjusted in regression models for gender, age, and treatment.ResultsThirty‐one patients elected to undertake non‐surgical management, and 29 chose surgery with a mean follow‐up of 34.8 ± 8.7 and 34.9 ± 7.0 months, respectively. The mean VISA‐H for the non‐surgical and surgical groups were 87.3 ± 3.4 and 87.9 ± 4.1 (n.s.), respectively. The mean FASH for the non‐surgical group was 89.3 ± 2.4 and 88 ± 3.6 for the surgical group (n.s.). This was consistent after adjusting for confounders.The mean gap for the non‐surgical group was 4.5 ± 1.09 and 4.9 ± 1.19 cm for the surgical group (n.s.). No significant differences were found in the abilities to perform Nordic hamstring curls (n.s.). Both groups achieved comparable RTS rates (n.s.). On average, the non‐surgical group achieved RTS at 5.5 ± 1.2 months post‐injury, whereas the surgical group was at 5.7 ± 0.7 months (n.s.).ConclusionPhysically active individuals with acute proximal hamstring avulsions and distal retraction of the tendon stump can be managed non‐surgically, achieving similar functional levels and RTS compared to patients treated surgically.Level of EvidenceLevel III.

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Inferior Clinical Outcomes Following Endoscopic Proximal Hamstring Repair in Patients With Chronic Degenerative Tears Despite the Use of Dermal Allograft Augmentation

Richards,

Marder,

Fasulo

et al. 2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Endoscopic Partial Proximal Hamstring Repair

Cited by 3 publications

References 18 publications

Association Between Proximal Hamstring Tear Characteristics and Achievement of Clinically Significant Outcomes After Endoscopic and Open Repair at Minimum 2-Year Follow-up

Association Between Proximal Hamstring Tear Characteristics and Achievement of Clinically Significant Outcomes After Endoscopic and Open Repair at Minimum 2-Year Follow-up

Non‐surgical management of acute proximal hamstring avulsions can produce clinically acceptable results

Inferior Clinical Outcomes Following Endoscopic Proximal Hamstring Repair in Patients With Chronic Degenerative Tears Despite the Use of Dermal Allograft Augmentation

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