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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 10, pp 3121–3124 | Cite as

Accelerated rehabilitation results in good outcomes following acute repair of proximal hamstring ruptures

  • Benjamin Léger-St-Jean
  • Zylyftar Gorica
  • Robert A. MagnussenEmail author
  • W. Kelton Vasileff
  • Christopher C. Kaeding
Hip

Abstract

Purpose

To assess outcomes of patients who underwent proximal hamstring repair utilizing an accelerated rehabilitation protocol with immediate weight bearing as tolerated and no bracing.

Methods

Retrospective chart review identified 47 proximal hamstring tendon repairs with suture anchors in 43 patients performed during 2008–2015. Rehabilitation included no immobilization or limited weightbearing. Patients were contacted by phone to assess outcomes utilizing the lower extremity functional score (LEFS), single-assessment numeric evaluation (SANE), and Marx activity scale. Overall patient-reported scores were calculated and results of acute and chronic repairs compared.

Results

Thirty-four patients (38 repairs, 80.8%) were available for follow-up at mean of 4.1 ± 2.0 years following repair. There were two re-tears: one complete rupture 5 weeks postoperative and one partial rupture 10 weeks postoperative in the chronic group. Patients in general reported low pain and good function with a mean LEFS score of 87 ± 21%, a mean SANE score of 88.1 ± 11.6, and a mean numeric pain score of 8.5 ± 15.3 in the last week and 12.2 ± 21.1 with activity. The acute repair group was noted to have a higher mean LEFS score (93.7 versus 79.8%, p = 0.004) and SANE score (91.3 versus 83.8, p = 0.047), and lower pain with activity (21.7 versus 4.8, p < 0.001) as compared to the chronic group.

Conclusions

Repair of acute proximal hamstring ruptures results in good function and pain relief with the use of a rehabilitation protocol that does not require weight-bearing restrictions or bracing.

Level of evidence

III, therapeutic.

Keywords

Proximal hamstring ruptures Proximal hamstring repairs Rehabilitation Weight-bearing 

Notes

Funding

No external funding source was used for this project.

Compliance with ethical standards

Conflict of interest

The authors report no relevant conflicts of interest for this study.

Ethical approval

Ethical approval for this study was provided by the Biomedical Institutional Review Board at The Ohio State University Wexner Medical Center.

References

  1. 1.
    Askling CM, Koulouris G, Saartok T, Werner S, Best TM (2013) Total proximal hamstring ruptures: clinical and MRI aspects including guidelines for postoperative rehabilitation. Knee Surg Sports Traumatol Arthrosc 21:515–533CrossRefGoogle Scholar
  2. 2.
    Chahal J, Bush-Joseph CA, Chow A, Zelazny A, Mather RC III, Lin EC, Gupta D, Verma NN (2012) Clinical and magnetic resonance imaging outcomes after surgical repair of complete proximal hamstring ruptures: does the tendon heal? Am J Sports Med 40:2325–2330CrossRefGoogle Scholar
  3. 3.
    Cohen S, Bradley J (2007) Acute proximal hamstring rupture. J Am Acad Orthop Surg 15:350–355CrossRefGoogle Scholar
  4. 4.
    Cohen SB, Rangavajjula A, Vyas D, Bradley JP (2012) Functional results and outcomes after repair of proximal hamstring avulsions. Am J Sports Med 40:2092–2098CrossRefGoogle Scholar
  5. 5.
    Harris JD, Griesser MJ, Best TM, Ellis TJ (2011) Treatment of proximal hamstring ruptures—a systematic review. Int J Sports Med 32:490–495CrossRefGoogle Scholar
  6. 6.
    Harvey MA, Singh H, Obopilwe E, Charette R, Miller S (2015) Proximal hamstring repair strength: a biomechanical analysis at 3 hip flexion angles. Orthop J Sports Med 3:2325967115576910CrossRefGoogle Scholar
  7. 7.
    Marx RG, Stump TJ, Jones EC, Wickiewicz TL, Warren RF (2001) Development and evaluation of an activity rating scale for disorders of the knee. Am J Sports Med 29:213–218CrossRefGoogle Scholar
  8. 8.
    Orava S, Kujala UM (1995) Rupture of the ischial origin of the hamstring muscles. Am J Sports Med 23:702–705CrossRefGoogle Scholar
  9. 9.
    Rust DA, Giveans MR, Stone RM, Samuelson KM, Larson CM (2014) Functional outcomes and return to sports after acute repair, chronic repair, and allograft reconstruction for proximal hamstring ruptures. Am J Sports Med 42:1377–1383CrossRefGoogle Scholar
  10. 10.
    Sallay PI, Ballard G, Hamersly S, Schrader M (2008) Subjective and functional outcomes following surgical repair of complete ruptures of the proximal hamstring complex. Orthopedics 31:1092CrossRefGoogle Scholar
  11. 11.
    Sallay PI, Friedman RL, Coogan PG, Garrett WE (1996) Hamstring muscle injuries among water skiers. Functional outcome and prevention. Am J Sports Med 24:130–136CrossRefGoogle Scholar
  12. 12.
    Sarimo J, Lempainen L, Mattila K, Orava S (2008) Complete proximal hamstring avulsions: a series of 41 patients with operative treatment. Am J Sports Med 36:1110–1115CrossRefGoogle Scholar
  13. 13.
    Schache AG, Dorn TW, Blanch PD, Brown NA, Pandy MG (2012) Mechanics of the human hamstring muscles during sprinting. Med Sci Sports Exerc 44:647–658CrossRefGoogle Scholar
  14. 14.
    Skaara HE, Moksnes H, Frihagen F, Stuge B (2013) Self-reported and performance-based functional outcomes after surgical repair of proximal hamstring avulsions. Am J Sports Med 41:2577–2584CrossRefGoogle Scholar
  15. 15.
    van der Made AD, Reurink G, Gouttebarge V, Tol JL, Kerkhoffs GM (2015) Outcome after surgical repair of proximal hamstring avulsions: a systematic review. Am J Sports Med 43:2841–2851CrossRefGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Benjamin Léger-St-Jean
    • 1
  • Zylyftar Gorica
    • 1
  • Robert A. Magnussen
    • 1
    • 2
    Email author
  • W. Kelton Vasileff
    • 1
    • 2
  • Christopher C. Kaeding
    • 1
    • 2
  1. 1.Department of Orthopaedics, College of MedicineThe Ohio State University Wexner Medical CenterColumbusUSA
  2. 2.OSU Sports Medicine Research InstituteThe Ohio State University Wexner Medical CenterColumbusUSA

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