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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Are Image-Guided Intraarticular Hip Injections Associated with an Increased Risk of Infection Following Hip Arthroscopy? Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Troy Amen, BA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
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What is the Association Between Anterior Cruciate Ligament Reconstruction and Femoroacetabular Impingement Surgery? An Analysis of Over 18,000 Hip Arthroscopies Abstract Presentation 6 minutes Clare Wise, BS , UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES Jeremy N. Truntzer, MD, UNITED STATES Robin Kamal, MD, MBA , 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
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Hip Labrum Reconstruction With A Polyurethane Scaffold: A Preliminary Report Of 3 Cases ePoster Presentation Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Raul Torres, MD, SPAIN Fernando Marques, MD, PhD., SPAIN Alfonso León, MD, PhD., SPAIN Oliver Marín-Peña, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Assessing Risk Of Osteonecrosis Of The Hip Following Intraarticular Injections: Hyaluronic Acid Versus Corticosteroid Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
The Relationship Between Early And Mid-Term Hip Arthroscopy Outcomes: Employing 3 Month Follow-Up To Predict Mid-Term Results Abstract Presentation 5 minutes Mario Hevesi, MD, PhD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Benjamin G. Domb, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Endoscopic Iliotibial Band Release During Hip Arthroscopy For Femoroacetabular Impingement Syndrome And External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study Abstract Presentation 5 minutes Chunbao Li, MD, PhD, CHINA Shanxing Zhang, MD, CHINA
Cleft Sign and Bone Marrow Edema of the Pubic Synthesis are Associated with Sports Activity and Bony Morphology Related to Femoroacetabular Impingement in Symptomatic Patients with Labral Tears: A Cohort Study Abstract Presentation 5 minutes Keisuke Nakayama, MD, PhD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Soshi Uchida, MD, PhD, JAPAN
Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis Abstract Presentation 9 minutes Casey Wang, MD, CANADA Dan Cohen, MD, CANADA Jeffrey Kay, MD, CANADA Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Carlomagno Cardenas-Nylander, MD, SPAIN Anil S. Ranawat, MD, UNITED STATES Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
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
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit from Arthroscopic Hip Surgery ePoster Presentation Benjamin Saks, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Andrew Jimenez, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES

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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