Sophia J Wang, Ryan T Halvorson, Joshua Chung, Rachel Yu, C Benjamin Ma, Stephanie E Wong, Alan L Zhang
{"title":"2010年至2022年的一项全国数据库分析显示,与重建相比,成年患者近端腘绳肌修复的失败率和并发症发生率更低。","authors":"Sophia J Wang, Ryan T Halvorson, Joshua Chung, Rachel Yu, C Benjamin Ma, Stephanie E Wong, Alan L Zhang","doi":"10.1016/j.arthro.2025.05.025","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare reoperation and complication rates after proximal hamstring repair and reconstruction in a large nationwide sample.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used a large nationwide insurance claims database with deidentified data (PearlDiver). Adult patients undergoing proximal hamstring repair (Current Procedural Terminology code 27385) or reconstruction (Current Procedural Terminology code 27386) with a diagnosis of proximal hamstring tear (International Classification of Diseases, Tenth Revision code S7631X) were included. A minimum 2-year follow-up was required. Rates of reoperation, emergency department (ED) utilization, and major complications (venous thromboembolism [VTE], sciatic nerve injury, and deep postoperative infection) were tabulated. Complication rates and ED utilization were compared using the Fisher exact test, and reoperations were assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>A total of 2,813 patients (54.2% female) were included, with 2,656 undergoing proximal hamstring repair and 157 undergoing proximal hamstring reconstruction from 2015 to 2022. Proximal hamstring repair patients showed a lower 2-year reoperation rate compared with reconstruction patients (2.8% vs 5.7%, P = .038). The overall rates of VTE, sciatic nerve injury, and infection were 2.73%, 0.76%, and 0.91%, respectively. Patients undergoing repair showed lower rates of infection (0.69% vs 4.55%, P < .001) but had similar rates of sciatic nerve injury (0.81% vs 0.0%, P = .263) and VTE (2.62% vs 4.55%, P = .156) compared with patients undergoing reconstruction. There were no significant differences in rates of postoperative hospitalization or ED utilization.</p><p><strong>Conclusions: </strong>Patients undergoing proximal hamstring repair showed lower reoperation and postoperative infection rates compared with patients undergoing proximal hamstring reconstruction.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nationwide Database Analysis Shows Proximal Hamstring Repair in Adult Patients Is Associated With Lower Failure and Complication Rates Than Reconstruction.\",\"authors\":\"Sophia J Wang, Ryan T Halvorson, Joshua Chung, Rachel Yu, C Benjamin Ma, Stephanie E Wong, Alan L Zhang\",\"doi\":\"10.1016/j.arthro.2025.05.025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare reoperation and complication rates after proximal hamstring repair and reconstruction in a large nationwide sample.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used a large nationwide insurance claims database with deidentified data (PearlDiver). Adult patients undergoing proximal hamstring repair (Current Procedural Terminology code 27385) or reconstruction (Current Procedural Terminology code 27386) with a diagnosis of proximal hamstring tear (International Classification of Diseases, Tenth Revision code S7631X) were included. A minimum 2-year follow-up was required. Rates of reoperation, emergency department (ED) utilization, and major complications (venous thromboembolism [VTE], sciatic nerve injury, and deep postoperative infection) were tabulated. Complication rates and ED utilization were compared using the Fisher exact test, and reoperations were assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>A total of 2,813 patients (54.2% female) were included, with 2,656 undergoing proximal hamstring repair and 157 undergoing proximal hamstring reconstruction from 2015 to 2022. Proximal hamstring repair patients showed a lower 2-year reoperation rate compared with reconstruction patients (2.8% vs 5.7%, P = .038). The overall rates of VTE, sciatic nerve injury, and infection were 2.73%, 0.76%, and 0.91%, respectively. Patients undergoing repair showed lower rates of infection (0.69% vs 4.55%, P < .001) but had similar rates of sciatic nerve injury (0.81% vs 0.0%, P = .263) and VTE (2.62% vs 4.55%, P = .156) compared with patients undergoing reconstruction. There were no significant differences in rates of postoperative hospitalization or ED utilization.</p><p><strong>Conclusions: </strong>Patients undergoing proximal hamstring repair showed lower reoperation and postoperative infection rates compared with patients undergoing proximal hamstring reconstruction.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative case series.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-05-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2025.05.025\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.05.025","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Nationwide Database Analysis Shows Proximal Hamstring Repair in Adult Patients Is Associated With Lower Failure and Complication Rates Than Reconstruction.
Purpose: To compare reoperation and complication rates after proximal hamstring repair and reconstruction in a large nationwide sample.
Methods: This retrospective cross-sectional study used a large nationwide insurance claims database with deidentified data (PearlDiver). Adult patients undergoing proximal hamstring repair (Current Procedural Terminology code 27385) or reconstruction (Current Procedural Terminology code 27386) with a diagnosis of proximal hamstring tear (International Classification of Diseases, Tenth Revision code S7631X) were included. A minimum 2-year follow-up was required. Rates of reoperation, emergency department (ED) utilization, and major complications (venous thromboembolism [VTE], sciatic nerve injury, and deep postoperative infection) were tabulated. Complication rates and ED utilization were compared using the Fisher exact test, and reoperations were assessed using Kaplan-Meier analysis.
Results: A total of 2,813 patients (54.2% female) were included, with 2,656 undergoing proximal hamstring repair and 157 undergoing proximal hamstring reconstruction from 2015 to 2022. Proximal hamstring repair patients showed a lower 2-year reoperation rate compared with reconstruction patients (2.8% vs 5.7%, P = .038). The overall rates of VTE, sciatic nerve injury, and infection were 2.73%, 0.76%, and 0.91%, respectively. Patients undergoing repair showed lower rates of infection (0.69% vs 4.55%, P < .001) but had similar rates of sciatic nerve injury (0.81% vs 0.0%, P = .263) and VTE (2.62% vs 4.55%, P = .156) compared with patients undergoing reconstruction. There were no significant differences in rates of postoperative hospitalization or ED utilization.
Conclusions: Patients undergoing proximal hamstring repair showed lower reoperation and postoperative infection rates compared with patients undergoing proximal hamstring reconstruction.
Level of evidence: Level III, retrospective comparative case series.
期刊介绍:
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.