ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Outcome Measures After Proximal Hamstring Repair: A Systematic Review

Tara Reza, MPH, New Orleans, LA UNITED STATES
Andre Gordon Perez-Chaumont, BS, Metairie, LA UNITED STATES
Andrew J Hinkle, BS, New Orleans, LA UNITED STATES
Symone M Brown, MPH, New Orleans, LA UNITED STATES
Mary K. Mulcahey, MD, New Orleans, LA UNITED STATES

Tulane University School of Medicine, New Orleans, Louisiana, UNITED STATES

FDA Status Not Applicable

Summary

This systematic review sought to identify and evaluate outcome measures used for proximal hamstring injuries, and found that there is currently no consensus on the best measurements in the evaluation of patients after this procedure; however, authors recommend an increased commitment to the use of Return to Sport, isokinetic strength testing, LEFS and PHAT in the evaluation of such injuries.

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Abstract

Introduction

Patient reported outcome measures are important to determine outcomes following orthopaedic procedures. There is currently no standard for outcome measures in the evaluation of patient outcomes following proximal hamstring repair. The purpose of this systematic review was to identify and evaluate outcome measures used for proximal hamstring injuries.

Methods

A systematic review was performed to identify all English-language articles assessing outcomes following proximal hamstring repair in PubMED, EMBASE, CINAHL via EBSCOhost, MEDLINE via OvidSP and Web of Science from 2000 to 2019. After duplicates were removed, studies were selected using eligibility criteria established by the authors. Image reviews, anatomic/histology studies, literature reviews, surgical technique reports, systematic reviews, narrative reviews, case studies, and studies with less than 5 patients were excluded. Extraction, synthesis, and analysis of outcome measure data were performed using Microsoft Excel. Quality assessment of included studies was performed using Methodological Index for Non-randomized Studies (MINORS) criteria.

Results

304 unique articles were identified and 27 met the inclusion criteria. The average number of proximal hamstring injuries per study was 40. Thirty different outcome measures were used. The most frequently reported outcome measures were Return to Sport (14/27, 51.9%), Custom Survey/Questionnaire (13/27, 48.2%), and Isokinetic Strength Testing (13/27, 48.2%). Six of the ten most commonly used outcome measures were validated, including Lower Extremity Functional Scale (LEF), Short-Form 12 (SF-12), Visual Analog Scale (VAS), Perth Hamstring Assessment Tool (PHAT), Single Assessment Numerical Evaluation (SANE) and Tegner Activity Scale (TAS). Of those, the Perth Hamstring Assessment Tool (PHAT) was the only validated outcome measure specifically designed for proximal hamstring repair. When comparing articles in journals with an impact factor <3 to those with an impact factor =3, there was a statistically significant difference between the average number of outcome scores (2.60 to 4.55, respectively; p=.01).

Conclusion

There is currently no consensus on the best outcome measurements in the evaluation of patients after proximal hamstring repair. We recommend an increased commitment to the use of Return to Sport, isokinetic strength testing, LEFS and PHAT in the evaluation of such injuries. Future studies should aim to define the most reliable methods in evaluation of these patients through consistent use of outcome measurements that are clinically relevant, important to patients and can easily be employed in a variety of clinical scenarios.

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