Summary: Following open proximal hamstring repair, African-American race as well as some specific comorbidities (diabetes, chronic kidney disease, and mood disorder) were predictive of poor postoperative outcomes, whereas lower BMI and higher pre-injury activity level predicted better outcomes postoperatively.

Introduction

Surgical repair of proximal hamstring tendon ruptures has been shown in multiple clinical outcome studies to be superior to nonoperative management. Improved functional scores and ability to return to sport postoperatively have been reported. However, few prior studies have investigated the preoperative clinical factors that may be predictive of postoperative outcome following proximal hamstring tendon repair.

Methods

A retrospective cohort study was conducted among patients who underwent open repair of the proximal hamstring performed by the senior author between August 2013 and June 2019. Three patient-reported outcome instruments were collected prospectively: Lower Extremity Functional Scale (LEFS), Marx Activity Scale (Marx), and the 12-Item Short Form Health Survey (SF-12). These surveys were initially administered preoperatively, then collected again at least one year following surgery.

Results

45 patients were eligible for inclusion (27 females, mean age: 51.1 ± 8.9 years, mean BMI: 27.3 ± 5.1). Average length of postoperative follow-up was 3.2 ± 1.7 years. Open proximal hamstring repair was associated with a statistically significant improvement in LEFS (p < 0.0001), Marx (p < 0.01), and SF-12 Physical Component scores (p < 0.0001). 63.0% of patients successfully returned to their pre-injury activity level (or higher), while 37.0% failed to return to the same level of activity after undergoing operative intervention. 51.8% of patients achieved the minimum clinically important difference (MCID) in Marx scores and 88.5% of patients achieved the MCID in SF-12 Physical Component scores.

African-American race, diabetes, and chronic kidney disease were significant predictors of poor postoperative outcome in LEFS (p = 0.028, p < 0.001, p < 0.001) and SF-12 Physical Component (p = 0.010, p < 0.001, p < 0.001) scores. A prior diagnosis of mood disorder also predicted poor outcomes in LEFS (p = 0.005) and Marx (p = 0.026) scores. In contrast, higher pre-injury activity level predicted better postoperative outcomes in LEFS (p = 0.026) and Marx (p < 0.001) scores, while lower BMI predicted better outcomes in Marx (p = 0.006) and SF-12 Mental Component (p = 0.006) scores. Interestingly, undergoing an injection (e.g. corticosteroid, platelet rich plasma) before proceeding to surgical intervention was a significant predictor of poor postoperative outcome in the SF-12 Mental Component score (p = 0.035).

The overall complication rate was 26.7%, with 11 patients undergoing a minor complication and 1 patient undergoing a major complication. 7 patients reported postoperative numbness in the posterior thigh and 5 patients experienced a wound healing problem, 1 of whom required reoperation for a surgical site infection on postoperative day 64. No proximal hamstring re-ruptures were observed during the study period. Complete hamstring avulsions had a higher risk of postoperative complication compared to partial hamstring tears (p = 0.023). Less time between the date of injury and the surgical procedure was also independently associated with a higher risk of postoperative complication (p = 0.044).

Conclusions

African-American race as well as some specific comorbidities (diabetes, chronic kidney disease, and mood disorder) were predictive of poor postoperative outcomes, whereas lower BMI and higher pre-injury activity level predicted better outcomes postoperatively. Complete hamstring avulsions had a higher overall complication rate than partial tears, and operating on proximal hamstring ruptures more acutely (i.e. closer to the date of injury) was also associated with a higher risk of postoperative complication.

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Promis Mobility: Evaluation Of The Lower Extremity-Specific Instrument In A Sports Medicine Hip Registry ePoster Presentation Molly A Day, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES
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Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Correlation Between Arthro-MRI Results And Intraoperative Hip Arthroscopy Findings In Fai Syndrome ePoster Presentation Christian Sobau, MD, GERMANY Konstantinos Tramountanis, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Alexander Zimmerer, MD, GERMANY
Efficacy Of Enoxaparin As A Thromboprophylactic Agent In Major Lower Limb Orthopedic Surgeries. ePoster Presentation Raghavendra Raju, MBBS,MS, INDIA Prasad Soraganvi, MBBS, MS, DNB, MRCS, SICOT-dip, INDIA
No Difference In Minimum Two-Year Patient-Reported Outcome Scores Between Circumferential And Segmental Labral Reconstruction For The Management Of Irreparable Labral Tear And Femoroacetabular Impingement Syndrome In The Primary Setting. ePoster Presentation David R. Maldonado, MD, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Jennifer Kurowicki, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Edward Milman, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES
Outcomes Of Revision Hip Arthroscopy Are Unaffected By Intraoperative Findings: A Matched Cohort Study ePoster Presentation Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Can Hip Pain Be Treated With Tibial Malrotation Correction? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
The Radiographical Influence Of Torsional Deformity Of The Acetabular And Femur In Dysplastic Hips ePoster Presentation Carsten Heimer, BA, GERMANY Carsten Perka, MD, PhD, GERMANY Henrik Baecker, MD, GERMANY
Can Hip Microinstability Be Predicted By Hip Range Of Motion Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Justin Hopkins, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Andrea Finlay, PhD, UNITED STATES Nicole Segovia Pham, MPH, UNITED STATES
Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes ePoster Presentation Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Steven Cecchi, BSc (Hons), MBBS, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter T. Annear, FRACS(Orth), AUSTRALIA
Not Every Hip Impingement Requires Hip Arthroscopy. Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Superior Outcomes With Routine Capsular Repair In Hip Arthroscopy Abstract Presentation 5 minutes Austin M Looney, MD, UNITED STATES Spencer M Comfort, BS, UNITED STATES Patrick T Connolly, BS, UNITED STATES Julia E McCann, MD, UNITED STATES Andrew Curley, MD, UNITED STATES William F. Postma, MD, UNITED STATES
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Efficacy Of Tranexamic Acid In Hip Fracture Surgeries ePoster Presentation Aabid Sanaullah, MBBS,MRCS,MRCPS,PGDipTrauma Surg.FEBOT,FRCSTr&Orth, UNITED KINGDOM Adeel Nawab Ditta, MBBS, MRCS, UNITED KINGDOM Olufunso Damilare Onayemi, MRCS MCH (Ortho), UNITED KINGDOM Ahsan Sheeraz, BSc MBBS MRCS, UNITED KINGDOM Atif A. Malik, MB ChB, MRCS Ed, MSc. (Orto. Eng), FRCS Tr & Orth, UNITED KINGDOM
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL

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Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair

Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair

Introduction

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Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair

Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair

Introduction

Methods

Results

Conclusions

More ISAKOS 2021: Global Content