Klinische Ergebnisse nach Refixation proximaler Hamstring-Sehnen-Rupturen unter Berücksichtigung verschiedener Ankersysteme

Clinical results after refixation of proximal hamstring tendon ruptures comparing different anchor systems

Zusammenfassung

Hintergrund

Verletzungen der ischiokruralen Muskulatur zählen zu den häufigsten Muskelverletzungen des Menschen, wobei der Abriss der proximalen Hamstring-Sehnen eine besonders schwerwiegende Form darstellt. Die operative Therapie dieser Verletzungen ist dem konservativen Management hinsichtlich Patientenzufriedenheit, Wiederherstellung der Muskelkraft und Funktion sowie „return to sports“ überlegen und deshalb Methode der Wahl.

Fragestellung

Darstellung und Vergleich der operativen Ergebnisse nach Versorgungen mit Titan‑, Polyetheretherketon(PEEK)- oder „All-suture“-Anker.

Material und Methoden

Es wurde eine systematische Literatursuche in der Medizindatenbank PubMed durchgeführt, und die Ergebnisse wurden zusammengefasst.

Ergebnisse

Alle Systeme zeigen vergleichbare biomechanische Elongations- sowie Maximallastwerte. Operationen mit diesen Ankern resultieren in guten klinischen Ergebnissen und weisen niedrige Komplikations- und eine hohe Return-to-sports-Raten auf. Die Patientenzufriedenheit nach Hamstring-Sehnen-Repair beträgt über 90 % und die Return-to-sports-Raten 80–100 %. Die Muskelkraft wird im Vergleich zur Gegenseite zu etwa 80–90 % wiederhergestellt.

Schlussfolgerung

Alle Ankertypen sind sicher anwendbar, und ein expliziter Vorteil für ein Ankersystem konnte bis dato nicht nachgewiesen werden.

Abstract

Background

Injuries to the hamstring muscles and tendon complex are among the most frequent muscular injuries with proximal hamstring tendon avulsion being a particularly severe form. The surgical treatment of these injuries is superior to conservative management with respect to patient satisfaction, recovery of muscle strength and function as well as return to sport rates. It is therefore the method of choice.

Objective

Presentation and comparison of the surgical results after treatment with titanium, polyether ether ketone (PEEK) and all suture anchors.

Material and methods

A systematic search was carried out in the PubMed medical database and the results are summarized.

Results

All systems exhibit comparable biomechanical properties regarding elongation and ultimate failure load. Tendon repair with these anchors results in good to excellent clinical outcomes and shows high return to sport and low complication rates. Patient satisfaction after hamstring tendon repair is reported to be over 90% and return to sport rate is 80–100%. The muscle strength recovers to 80–90% in comparison to the contralateral side.

Conclusion

All available anchors systems provide good to excellent clinical outcomes and an explicit advantage for one anchor system could so far not be shown.

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Correspondence to A. B. Imhoff.

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Interessenkonflikt

M. Irger, P. Forkel, A.B. Imhoff und L. Willinger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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T. Mittlmeier, Rostock

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Irger, M., Forkel, P., Imhoff, A.B. et al. Klinische Ergebnisse nach Refixation proximaler Hamstring-Sehnen-Rupturen unter Berücksichtigung verschiedener Ankersysteme. Unfallchirurg 124, 560–567 (2021). https://doi.org/10.1007/s00113-021-01020-8

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Schlüsselwörter

  • Sehnenverletzungen
  • Frakturfixation
  • Knochenanker
  • Patientenzufriedenheit
  • „Return to sport“

Keywords

  • Tendon injuries
  • Fracture fixation
  • Bone anchors
  • Patient satisfaction
  • Return to sport