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Increased time from injury to surgical repair in patients with proximal hamstring ruptures is associated with worse clinical outcomes at mid-term follow-up

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Prior studies of hamstring tendon tears have reported varied findings on whether increased delay from injury to surgery is associated with worse outcomes. The purpose of this study was to determine whether increased time from injury to surgical repair is associated with worse clinical outcomes in patients with proximal hamstring ruptures.

Materials and methods

Patients who underwent surgical repair of a proximal hamstring rupture from 2010 to 2019 were followed for a minimum of 24 months from surgery. A cutoff of 6 weeks from injury to the time of surgery was used to distinguish between acute and chronic ruptures. All patients completed patient-reported outcome measures (PROs) at the final follow-up. Multiple factors were analyzed for their effects on PROs including time to surgery, amount of tendon retraction, and demographics such as sex and age.

Results

Complete data sets were obtained for 38 patients at a mean follow-up of 4.9 years. All data is reported as a mean ± standard deviation. Patients who underwent acute repair of proximal hamstring ruptures had significantly greater Perth Hamstring Assessment Tool (PHAT) scores than those who underwent chronic repair (76.9 ± 18.8 vs 60.6 ± 18.2, p = 0.01). Increased time to surgery was significantly correlated with worse PHAT scores (ρ = − 0.47, p = 0.003). There was no difference in PROs based on the amount of tendon retraction, number of tendons torn, sex, smoking status, or BMI.

Conclusions

This study found that acute repair performed within 6 weeks of injury appears to yield improved PROs compared to chronic repair. These data highlight the importance of timely and accurate diagnosis of proximal hamstring ruptures and early operative intervention for surgical candidates.

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Abbreviations

PEEK:

Polyether Ether Ketone

PRO:

Patient Reported Outcome

PHAT:

Perth Hamstring Assessment Tool

MHHS:

Modified Harris Hip Score

VAS:

Visual Analogue Scale for Pain

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th st, 14th floor, New York, NY, 10003, United States

    Ajay C. Kanakamedala, Edward S. Mojica, Eoghan T. Hurley, Guillem Gonzalez-Lomas, Laith M. Jazrawi & Thomas Youm

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  1. Ajay C. Kanakamedala
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  2. Edward S. Mojica
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  3. Eoghan T. Hurley
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  4. Guillem Gonzalez-Lomas
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  5. Laith M. Jazrawi
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  6. Thomas Youm
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Correspondence to Ajay C. Kanakamedala.

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Conflict of interest

Thomas Youm is a paid consultant for Arthrex. Laith Jazrawi is a member of the editorial or governing board for Bulleting to the Hospital for Joint Diseases and JBJS Reviews, receives publishing royalties from Wolters Kluwers Health—Lippincott Williams & Wilkins, and receives research support from Arthrex, Smith & Nephew, and Mitek. None of these disclosures are relevant to the current work, and no industry or other external support was provided for this study. The authors declare no other potential conflicts of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. IRB approval (i20-00889) was obtained prior to commencing the study.

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Informed consent was obtained from all individual participants included in the study.

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Kanakamedala, A.C., Mojica, E.S., Hurley, E.T. et al. Increased time from injury to surgical repair in patients with proximal hamstring ruptures is associated with worse clinical outcomes at mid-term follow-up. Arch Orthop Trauma Surg 143, 951–957 (2023). https://doi.org/10.1007/s00402-022-04421-5

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  • DOI: https://doi.org/10.1007/s00402-022-04421-5

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