Successful return to high level sports following early surgical repair of complete tears of the proximal hamstring tendons

Abstract

The purpose of this study was to investigate the outcome of surgical management of acute complete proximal hamstring tendon tears. This was a prospective review of a case series from a tertiary referral centre. Ten patients presenting with complete proximal hamstring tendon tears were confirmed on MRI. All patients underwent surgical exploration and repair of the torn tendons with the aim of returning to normal activities and sports. Isokinetic muscle testing was performed using a dynamometer. The Cybex dynamometer (Cybex International, Ronkonkowa, NY) testing revealed almost comparable readings for the operated versus the nonoperated side. An average peak torque of the operated hamstring muscles of 82.78% (range 47.16-117.88%), compared to the contralateral leg, was noted at six months. An excellent outcome was found in terms of return to normal activities and sports. Early surgical repair and physiotherapy has been noted to be associated with a good outcome and enables an early return to high level sports after complete tear of the proximal hamstring tendons.

Self-Reported and Performance-Based Functional Outcomes After Surgical Repair of Proximal Hamstring Avulsions

“…7,[27][28][29]41 In the present study, 18 (58%) of the patients reported that they had regained preinjury activity level at a mean of 9 months (range, 3-18 months and Cohen et al 13 reported concerns of reinjury as one of the reasons why the patients did not return to all preinjury activities after surgical repair of proximal total hamstring rupture.…”

“…9,18,27 The mean peak torque of the injured leg for knee flexion was 84% of the uninjured, while the mean total work of the injured leg for knee flexion was 81%. Eighteen (60%) patients had a LSI of < 85% for peak torque hamstring strength.…”

“…9,28,37,41 Isokinetic muscle strength has been used as a performance-based outcome, showing a mean limb symmetry index (LSI) between 80% and 95%, although most of the studies have included few patients. 9,18,27,36 Only 2 previous studies have assessed performance-based outcomes after surgical treatment in a larger population (n > 20). 7,41 The patients' subjective feeling of confidence is important for a return to their preinjury level of activity.…”

Evaluation and Imaging of an Untreated Grade III Hamstring Tear: A Case Report

“…Tears of the proximal hamstring tendons can be addressed surgically [22]. Surgeons are more likely to recommend repair of proximal hamstring-origin complete avulsions because of the risk for tendon retraction and progressive functional impairment with time [29], whereas the majority of hamstring muscle injuries respond well to nonoperative treatment [5,36].…”

Endoscopic Proximal Hamstring Repair and Ischial Bursectomy

“…13,14 Occasionally, patients who present with either acute or chronic tears may complain of a pins-andneedles sensation in the sciatic nerve distribution, much like sciatica. 14,15 This may be due to the acute compression of a hematoma in the proximity of the sciatic nerve or chronic scarring and tethering of the tendon to the nerve. Similarly, symptoms of ischial bursitis include buttock pain or hip pain, as well as localized tenderness overlying the ischial tuberosity.…”