Returning to sports after surgical repair of acute proximal hamstring ruptures

Lefèvre, Nicolas; Bohu, Yoann; Naouri, J.-F.; Klouche, Shahnaz; Herman, S.

doi:10.1007/s00167-012-2204-2

Cited by 49 publications

(44 citation statements)

References 25 publications

(36 reference statements)

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“…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.…”

Section: Discussionmentioning

confidence: 44%

“…13,14,26,36 Return to preinjury level of sport and patient satisfaction are usually used as main outcomes after undergoing repair of proximal hamstring tendon rupture. 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).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Skaara, H. E., Moksnes, H., Frihagen, F. J., Stuge, B. (2013 Purpose: To examine lower extremity function after surgical repair of proximal hamstring avulsions using validated self-reported and performance-based functional outcomes. Study Design: Case seriesMethods: Operative records from 2006 to 2010 were retrospectively reviewed in 3 hospitals.A total of 39 patients who undergone surgical repair of proximal hamstring avulsion were identified and 36 met the inclusion criteria. Thirty-one patients completed questionnaires with demographic background data and quality of life related questions, Lower Extremity Functional Scale (LEFS) and Proximal Hamstring Injury Questionnaire (PHIQ). Thirty patients were evaluated using a Biodex dynamometer for isokinetic quadriceps and hamstring strength measurement at a velocity of 60 deg/s, and 27 patients performed 4 single-legged hop tests.Results: Twenty-eight repairs were acute (< 4 weeks), and 3 were chronic. There were complete ruptures of all 3 tendons in 17 (55%) cases. The mean follow-up was 30 months.Most patients experienced little or no pain or limitations during activities of daily living. The mean LEFS score was 89%, and 29 (94%) of the 31 patients were satisfied with the result 2 after surgery. Eighteen (58%) of the 31 patients had returned to their pre-injury activity level.Significant differences in the mean hamstring strength (peak torque) (P< .001) and single hop for distance (P = .01) between the uninvolved and the involved leg were found. Twenty-two (71%) of the 31 patients did not fully trust their operated leg during physical activities and feared for sustaining a hamstring injury. Return to activity significantly correlated with the single hop for distance test, LEFS and the questions regarding trust and fear. Conclusion:In this study, using both validated self-reported and performance-based outcome measures after surgical repair of proximal hamstring tendon avulsion, minor pain and limitations to activities of daily living were seen. Isokinetic hamstring muscle strength in the operated leg was significantly lower compared to the nonoperated leg, and a majority of the patients did not trust the operated leg completely during physical activity

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Section: Discussionmentioning

confidence: 44%

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…Sallay et al 14 and Rust et al 12 described immobilization of the knee at 90° for 4 to 6 weeks. Lefevre et al 9 , 10 and Chahal et al 4 described immobilization of the knee at 30° for 6 weeks. Mansour et al 11 described using a hinged knee brace to limit extension for a minimum of 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

Proximal Hamstring Repair Strength

Harvey¹,

Singh

Obopilwe

et al. 2015

Orthopaedic Journal of Sports Medicine

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Background:Proximal hamstring repair for complete ruptures has become a common treatment. There is no consensus in the literature about postoperative rehabilitation protocols following proximal hamstring repair. Some protocols describe bracing to prevent hip flexion or knee extension while others describe no immobilization. There are currently no biomechanical studies evaluating proximal hamstring repairs; nor are there any studies evaluating the effect of different hip flexion angles on these repairs.Hypothesis:As hip flexion increases from 0° to 90°, there will be a greater gap with cyclical loading.Study Design:Controlled laboratory study.Methods:Proximal hamstring insertions were detached from the ischial tuberosity in 24 cadavers and were repaired with 3 single-loaded suture anchors in the hamstring footprint with a Krakow suture technique. Cyclic loading from 10 to 125 N at 1 Hz was then performed for 0°, 45°, and 90° of hip flexion for 1500 cycles. Gap formation, stiffness, yield load, ultimate load, and energy to ultimate load were compared between groups using paired t tests.Results:Cyclic loading demonstrated the least amount of gap formation (P < .05) at 0° of hip flexion (2.39 mm) and most at 90° of hip flexion (4.19 mm). There was no significant difference in ultimate load between hip flexion angles (326, 309, and 338 N at 0°, 45°, and 90°, respectively). The most common mode of failure occurred with knot/suture failure (n = 17).Conclusion:Increasing hip flexion from 0° to 90° increases the displacement across proximal hamstring repairs. Postoperative bracing that limits hip flexion should be considered.Clinical Relevance:Repetitive motion involving hip flexion after a proximal hamstring repair may cause compromise of the repair.

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“…It occurs mainly as a result of soft tissue avulsion alone or with a bone fragment detached from the ischial tuberosity, at the proximal tip of the muscle, but is considered to be very rare [20]. When this type of injury occurs to a soccer player he may often need surgical intervention [4,[21][22][23]. Magnetic resonance imaging or sonography will aid in the diagnosis of the scope of damage caused.…”

Section: Degree Of Damage Causedmentioning

confidence: 99%