Purpose

To investigate factors associated with the need for revision surgery following primary proximal hamstring tendon repair in the context of an acute or chronic rupture.

Methods

This study included 206 patients that underwent primary proximal hamstring tendon repair surgery by one of two orthopaedic surgeons due to an acute rupture (n=139) or chronic tear (n=67). The acute and chronic proximal hamstring repair cohorts were analyzed separately, and regression analysis was used to investigate the contribution of a range of variables to the need for revision surgery within at least two years of primary surgery, including age at surgery, body mass index (BMI), biological sex, time from injury to surgery (for acute repairs) and comorbidities including hypertension, hypercholesterolaemia and Type 2 diabetes. Odds ratios and confidence intervals were reported for the variables associated with outcome.

Results

Of the 206 patients that underwent surgery and were included in the analysis, 26 (12.6%) underwent revision surgery due to re-tearing and recurrence of symptoms, which included 15 of 139 (10.8%) of the acute cohort and 11 of 67 (16.4%) of the chronic cohort. Within the acute cohort, biological sex was a significant predictor of revision proximal hamstring repair. Females exhibited an odds ratio (OR) of 3.83 (95% confidence interval [CI], 1.18 to 12.50; p=0.026), indicating that were approximately 3.8 times more likely to undergo revision proximal hamstring repair compared to males. Within the chronic cohort, no variables were shown to be a significant predictor of the need for revision surgery.

Conclusions

While females were significantly more likely to undergo revision surgery following primary proximal hamstring tendon repair in the context of an acute rupture, no other variables were predictive of the need for revision surgery within at least two years of primary repair of an acute rupture or chronic tear.