采用全缝合锚和加速康复与支撑方案进行腘绳肌近端修复术，1 年随访结果良好

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-02-10 DOI:10.1016/j.asmr.2024.100891

Stephanie E. Wong M.D. , Kaitlyn R. Julian B.S. , Jocelyn G. Carpio B.S. , Alan L. Zhang M.D.

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引用次数: 0

摘要

目的评估使用全缝合固定器和独特的术后支撑策略手术治疗腘绳肌腱近端断裂后的患者报告结果和再断裂风险。方法对一家三级学术机构 2020 年至 2022 年期间接受腘绳肌腱近端修复或重建手术的患者的前瞻性数据库进行回顾性审查。患者随访至少1年，并完成术后患者报告结果，即被纳入其中。腘绳肌近端修复的手术方案包括在峡部结节以开放或内窥镜方式放置全缝合锚。术后，所有患者都接受了加速康复方案，包括在伸展锁定的铰链式膝关节支架上进行为期6周的触地负重行走，坐位时膝关节可被动屈曲至90°。结果21名患者（平均年龄50.4±9.5岁，体重指数24.4±3.5，66.7%为女性）被纳入其中。术后下肢功能量表评分为 74.2 ± 7.5（满分 80 分）。患者的疼痛感极低（平均视觉模拟量表疼痛评分为 0.9 ± 1.2）。根据 Tegner 评分，61.9% 的患者在术后 1 年能够恢复到相同的活动水平。术后单项数字评估日常生活活动能力为（94.3 ± 8.3），单项数字评估运动能力为（82.3 ± 19.0）。术后平均简表调查（SF-12）得分分别为：SF-12身体成分得分（51.6 ± 6.8）和心理成分得分（53.9 ± 9.7）。95.2%的患者（21 人中有 20 人）对手术结果表示满意。没有再破裂、感染或再次手术。21例患者中有1例（4.8%）术后发生了深静脉血栓，经过3个月的抗凝治疗后，患者恢复良好。

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Proximal Hamstring Repair With All-Suture Anchors and an Accelerated Rehabilitation and Bracing Protocol Demonstrates Good Outcomes at 1-Year Follow-Up

Purpose

To evaluate patient-reported outcomes and risk for rerupture after surgical treatment of proximal hamstring tendon ruptures using all-suture anchors and a unique postoperative bracing strategy.

Methods

A retrospective review of a prospectively collected database was conducted of patients undergoing proximal hamstring repair or reconstruction from 2020 to 2022 at a tertiary, academic institution. Patients were included if they reached minimum 1-year follow-up and completed postoperative patient-reported outcomes. The surgical protocol for proximal hamstring repairs included all-suture anchors placed either in an open or endoscopic fashion in the ischial tuberosity. After surgery, all patients underwent an accelerated rehabilitation protocol, including 6 weeks touchdown weight-bearing in a hinged knee brace locked in extension for ambulation, allowing passive knee flexion to 90° while seated. Descriptive statistics were used to analyze the data.

Results

Twenty-one patients were included (mean age 50.4 ± 9.5 years, body mass index 24.4 ± 3.5, 66.7% female). Lower Extremity Functional Scale score achieved postoperatively was 74.2 ± 7.5 (out of 80). Patients had minimal pain (mean visual analog scale pain score of 0.9 ± 1.2). 61.9% of patients were able to return to the same level of activity after based on Tegner score by 1 year. Postoperative Single Assessment Numeric Evaluation activity of daily living was 94.3 ± 8.3, and Single Assessment Numeric Evaluation Sports was 82.3 ± 19.0. Mean Short Form Survey (SF-12) postoperative scores were 51.6 ± 6.8 for SF-12 Physical Component Score and 53.9 ± 9.7 for Mental Component Score. 95.2% (20 of 21) patients were satisfied with their outcome. There were no reruptures, infections, or reoperations. One patient of 21 (4.8%) incurred a postoperative deep venous thrombosis, which was treated with therapeutic anticoagulation for 3 months.

Conclusions

All-suture anchors for proximal hamstring repair with a unique accelerated postoperative rehabilitation and bracing protocol result in good outcomes and patient satisfaction with minimal risk of complications.