Surgery may improve function after proximal hamstring avulsion vs. nonoperative treatment
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Key takeaways:
- Surgical treatment of proximal hamstring avulsion injuries was associated with improved outcomes vs. nonoperative management.
- Surgery yielded improved function, return to sport and patient satisfaction.
Published results showed surgical treatment of proximal hamstring avulsion injuries was associated with improved functional outcomes at long-term follow-up compared with nonoperative treatment.
Nicolas Lefèvre, MD, orthopedic surgeon at the Clinique du Sport in Paris, and colleagues performed a retrospective comparative study of data from patients treated for a proximal hamstring avulsion injury between January 2012 and July 2021.
Lefèvre and colleagues compared outcomes between a cohort of 95 patients who underwent surgical treatment of the proximal hamstring avulsion injury at mean 5.7 months after injury and 32 patients who received nonoperative management of the proximal hamstring avulsion injury at a mean 12.7 months after injury.
According to the study, outcome measures were assessed at a minimum follow-up of 4 years and included the Parisian Hamstring Avulsion Score, Tegner activity score, University of California Los Angeles (UCLA) score, return to sport and patient satisfaction.
At final follow-up, mean Parisian Hamstring Avulsion Score was 86.3 for the surgical group at a mean 50.7 months and was 69.9 for the nonsurgical group at a mean 56.5 months. Lefèvre and colleagues also found patients who underwent surgery had higher Tegner activity scores and UCLA scores compared with patients who received nonoperative treatment.
Lefèvre and colleagues noted 68.4% of the surgical group returned to sport with 67.7% returning at the same or higher level, while 46.9% of the nonsurgical group returned to sport with 26.7% returning at the same or higher level. In addition, they noted 89.5% of the surgical group and 25% of the nonsurgical group reported high patient satisfaction after treatment.
“It is noteworthy that surgical intervention carries an additional 3% risk of complications, which in this study included issues such as re-rupture and paresthesia,” Lefèvre and colleagues wrote in the study. “This rate is comparable with the rate reported in the literature.”
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