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

Ebert, Jay R.; Gormack, Nicholas; Annear, Peter

doi:10.1007/s00167-018-5310-y

Cited by 11 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PHAT is one of the few validated outcome measures tailored to proximal hamstring tendon repair, as opposed to measures that apply to a broad scope of lower limb or musculoskeletal injuries. 11 PHAT was used in 4 studies 6,10,11,20 ; however, 2 of these were written by the same author, 10,11 which creates a risk of bias.Further research is needed to determine if PHAT should be implemented widely to evaluate outcomes in patients after proximal hamstring repair.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Outcome Measures Used After Proximal Hamstring Repair

Reza

Hinkle

Perez-Chaumont

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Patient-reported outcome measures are important to determine outcomes after orthopaedic procedures. There is currently no standard for outcome measures in the evaluation of patient outcomes after proximal hamstring repair. Purpose: To identify and evaluate outcome measures used after proximal hamstring repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed to identify all English-language articles assessing outcomes after proximal hamstring repair in PubMed, Embase, CINAHL via EBSCOhost, MEDLINE via OvidSP, and Web of Science between 2000 and 2019. After duplicates were removed, studies were selected using eligibility criteria established by the authors. Image reviews, anatomic/histology studies, literature reviews, surgical technique reports, systematic reviews, narrative reviews, case studies, and studies with <5 patients were excluded. Extraction, synthesis, and analysis of outcome measure data were performed using Microsoft Excel. Quality assessment of included studies was performed using Methodological Index for Non-Randomized Studies criteria. Results: After duplicate articles were removed, a total of 304 unique articles were identified and 27 met the inclusion criteria. The mean number of patients with proximal hamstring repairs per study was 40. The most frequently reported outcome measures were return to sport (14/27; 51.9%), custom survey/questionnaire (13/27; 48.1%), and isokinetic hamstring strength testing (13/27; 48.1%). Six of the 10 most commonly used outcome measures were validated and included Lower Extremity Functional Scale, 12-Item Short Form Health Survey, visual analog scale for pain, Perth Hamstring Assessment Tool (PHAT), Single Assessment Numeric Evaluation, and Tegner Activity Scale. Of those, PHAT was the only validated outcome measure designed for proximal hamstring repair. Conclusion: There is currently no consensus on the best outcome measurements for the evaluation of patients after proximal hamstring repair. We recommend an increased commitment to the use of return to sport, isokinetic strength testing, Lower Extremity Functional Scale, and PHAT when assessing such injuries. Future studies should aim to define the most reliable methods of outcome measurement in this patient population through consistent use of tools that are clinically relevant and important to patients and can easily be employed in a variety of clinical scenarios.

show abstract

Section: Discussionmentioning

confidence: 99%

Systematic Review of Outcome Measures Used After Proximal Hamstring Repair

Reza

Hinkle

Perez-Chaumont

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…5 While most techniques involve use of Achilles tendon allograft, other grafts have been described. Ebert et al 14 reported a case series of 6 patients who underwent reconstruction of chronic proximal hamstring avulsion injuries using ipsilateral distal hamstring autograft. They noted good outcomes with improved strength and endurance as well as return to recreational and sporting activities.…”

Section: Discussionmentioning

confidence: 99%

“…The knee was positioned in 90 flexion for fixation to the ischial tuberosity, which was accomplished using 2 suture anchors. Others have similarly used only 2 to 3 suture anchors for attachment to the tuberosity such as in the previously cited series by Klingele and Sallay, Ebert, as well as Atzmon et al 9,13,14 However, as described in a study by Moatshe et al, 17 the use of 5 anchors is biomechanically stronger and more similar to native hamstring tendon strength. While this technique was used in repair of acute injuries, the use of 5 suture anchors may improve strength of chronic reconstructions as well.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Chronic Proximal Hamstring Tear: Description of a Surgical Technique

Grasso

O’Neill

Constantinescu

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

While proximal hamstring tears at the myotendinous junction are common sports-related injuries that are often successfully treated nonoperatively, complete avulsions from the origin on the ischial tuberosity are less common and better treated with surgical repair to prevent significant functional limitations and ongoing weakness. The diagnosis can be easily missed, leading patients to present several months after the initial injury. In addition, some patients decide on nonoperative management initially but later present requesting surgical intervention. The delayed cases are challenging due to often significant tendon retraction, making direct repair difficult if not impossible. Techniques using allograft and autograft reconstruction have been described for this clinical situation. This Technical Note describes the use of 2 Achilles tendon allografts fixed via 5 suture anchors to reconstruct a chronic complete avulsion injury of the proximal hamstring with >5-cm retraction.A cute strains of the hamstring muscle group are

show abstract

“…Furthermore, as will be described below, it can be used either with a bone plug, or as an all-soft tissue graft. Other graft options described in the literature include semitendinosus and gracilis autograft, obtained either from the ipsilateral [29] or contralateral [24] knee, and iliotibial band autograft [9].…”

Section: Graft Selectionmentioning

confidence: 99%

“…It is also the technique more familiar to most surgeons, since most acute repairs are performed in a similar manner. Many different anchor options have been described in the context of proximal hamstring repair, including PEEK [24,29] and bioabsorbable [27] implants. The anchors are inserted into the lateral aspect of the ischial tuberosity, 1 cm apart, and are incorporated into the repair as described below.…”

Section: Suture Anchorsmentioning

confidence: 99%