Open Surgical Repair of Proximal Hamstring Tears Results in High Rates of Hamstring Strength Recovery and Return to Preinjury Activity.

Abstract

Purpose: To evaluate the clinical and patient-reported outcomes after open operative management of proximal hamstring ruptures.

Methods: Retrospective chart review was completed for patients who underwent open surgical repair of a proximal hamstring rupture at a single academic center (The Ottawa Hospital) with a minimum of 1-year follow-up between June 2017 and August 2022. Demographic, injury, and surgical data were collected. Patient-reported outcomes, including the Lower Extremity Function Score and International Hip Outcome Tool, at final follow-up were collected and analyzed for all patients.

Results: A total of 41 patients (58.5% men) with a mean age of 49.5 ± 11.7 years (range: 20-70 years old) with a mean follow-up of 46.8 ± 17.6 months (range 13-74 months) were included in the study. The most common mechanism of injury (31.7%) was a fall while skating or skiing. A 3-tendon injury was the most common pattern (82.9%), with the majority being retracted at least 6 cm (51.2%). Postoperative complications were observed in 12.2% of patients and included sensory nerve injury, repair failure, and postoperative admission for intractable pain. Most patients regained full hamstring strength (87.8%) and returned to preinjury activity levels (70.7%), with a mean follow-up of 46.8 months. Patient-reported outcomes at final follow-up were excellent, as 87.8% of the patients scored >90 on Lower Extremity Function Score and 82.9% scored >90 on International Hip Outcome Tool.

Conclusions: In this study, patients who underwent open surgical repair of proximal hamstring tendon avulsion had high rates of hamstring strength recovery and return to preinjury activity, with favorable patient-reported outcomes and low complication rates.

Level of evidence: Level IV, therapeutic retrospective study.