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Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis

AIMS: Avulsion of the proximal hamstring tendon origin can result in significant functional impairment, with surgical re-attachment of the tendons becoming an increasingly recognized treatment. The aim of this study was to assess the outcomes of surgical management of proximal hamstring tendon avuls...

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Autores principales: Hillier-Smith, Ryan, Paton, Bruce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134830/
https://www.ncbi.nlm.nih.gov/pubmed/35549447
http://dx.doi.org/10.1302/2633-1462.35.BJO-2021-0196.R1
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author Hillier-Smith, Ryan
Paton, Bruce
author_facet Hillier-Smith, Ryan
Paton, Bruce
author_sort Hillier-Smith, Ryan
collection PubMed
description AIMS: Avulsion of the proximal hamstring tendon origin can result in significant functional impairment, with surgical re-attachment of the tendons becoming an increasingly recognized treatment. The aim of this study was to assess the outcomes of surgical management of proximal hamstring tendon avulsions, and to compare the results between acute and chronic repairs, as well as between partial and complete injuries. METHODS: PubMed, CINAHL, SPORTdiscuss, Cochrane Library, EMBASE, and Web of Science were searched. Studies were screened and quality assessed. RESULTS: In all, 35 studies (1,530 surgically-repaired hamstrings) were included. Mean age at time of repair was 44.7 years (12 to 78). A total of 846 tears were acute, and 684 were chronic, with 520 tears being defined as partial, and 916 as complete. Overall, 92.6% of patients were satisfied with the outcome of their surgery. Mean Lower Extremity Functional Score was 74.7, and was significantly higher in the partial injury group. Mean postoperative hamstring strength was 87.0% of the uninjured limb, and was higher in the partial group. The return to sport (RTS) rate was 84.5%, averaging at a return of 6.5 months. RTS was quicker in the acute group. Re-rupture rate was 1.2% overall, and was lower in the acute group. Sciatic nerve dysfunction rate was 3.5% overall, and lower in the acute group (p < 0.05 in all cases). CONCLUSION: Surgical treatment results in high satisfaction rates, with good functional outcomes, restoration of muscle strength, and RTS. Partial injuries could expect a higher functional outcome and muscle strength return. Acute repairs result in a quicker RTS with a reduced rate of re-rupture and sciatic nerve dysfunction. Cite this article: Bone Jt Open 2022;3(5):415–422.
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spelling pubmed-91348302022-06-09 Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis Hillier-Smith, Ryan Paton, Bruce Bone Jt Open Systematic Review AIMS: Avulsion of the proximal hamstring tendon origin can result in significant functional impairment, with surgical re-attachment of the tendons becoming an increasingly recognized treatment. The aim of this study was to assess the outcomes of surgical management of proximal hamstring tendon avulsions, and to compare the results between acute and chronic repairs, as well as between partial and complete injuries. METHODS: PubMed, CINAHL, SPORTdiscuss, Cochrane Library, EMBASE, and Web of Science were searched. Studies were screened and quality assessed. RESULTS: In all, 35 studies (1,530 surgically-repaired hamstrings) were included. Mean age at time of repair was 44.7 years (12 to 78). A total of 846 tears were acute, and 684 were chronic, with 520 tears being defined as partial, and 916 as complete. Overall, 92.6% of patients were satisfied with the outcome of their surgery. Mean Lower Extremity Functional Score was 74.7, and was significantly higher in the partial injury group. Mean postoperative hamstring strength was 87.0% of the uninjured limb, and was higher in the partial group. The return to sport (RTS) rate was 84.5%, averaging at a return of 6.5 months. RTS was quicker in the acute group. Re-rupture rate was 1.2% overall, and was lower in the acute group. Sciatic nerve dysfunction rate was 3.5% overall, and lower in the acute group (p < 0.05 in all cases). CONCLUSION: Surgical treatment results in high satisfaction rates, with good functional outcomes, restoration of muscle strength, and RTS. Partial injuries could expect a higher functional outcome and muscle strength return. Acute repairs result in a quicker RTS with a reduced rate of re-rupture and sciatic nerve dysfunction. Cite this article: Bone Jt Open 2022;3(5):415–422. The British Editorial Society of Bone & Joint Surgery 2022-05-13 /pmc/articles/PMC9134830/ /pubmed/35549447 http://dx.doi.org/10.1302/2633-1462.35.BJO-2021-0196.R1 Text en © 2022 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Systematic Review
Hillier-Smith, Ryan
Paton, Bruce
Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
title Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
title_full Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
title_fullStr Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
title_full_unstemmed Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
title_short Outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
title_sort outcomes following surgical management of proximal hamstring tendon avulsions: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134830/
https://www.ncbi.nlm.nih.gov/pubmed/35549447
http://dx.doi.org/10.1302/2633-1462.35.BJO-2021-0196.R1
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