Pre-op Activity and Injury Mechanism Impact 2-Year Outcomes Post Proximal Hamstring Repair

Overview

This prospective study of 59 patients undergoing acute proximal hamstring tendon repair found significant improvements in clinical outcomes at 2 years post-surgery. Patient demographics, injury mechanisms, and post-operative factors were analyzed to identify predictors of better functional outcomes and satisfaction.

Background

Proximal hamstring tendon ruptures represent about 12% of hamstring injuries and often require surgical repair for optimal recovery. While non-operative management may be considered for select cases, surgical repair generally yields superior outcomes, especially when performed acutely. Previous studies have shown mixed associations between patient factors and outcomes, highlighting the need for prospective data to guide pre-operative counseling and expectation management.

Data Highlights

Key Findings

• Significant improvement in PHAT and LEFS scores from baseline to 2 years post-surgery.
• Higher patient-reported functional outcomes associated with female sex and delayed surgery timeframe in prior studies, though this study focused on acute repairs within 6 weeks.
• Mechanism of injury categorized as sporting, recreational, or work/ADL/accident activities to assess impact on outcomes.
• Post-operative rehabilitation protocols included early partial weight bearing, progressive range of motion, and strength conditioning under therapist guidance.
• Patient satisfaction assessed via Likert scale showed majority achieving 'Very Satisfied' or 'Somewhat Satisfied' status at 2 years.

Clinical Implications

Clinicians should consider that acute surgical repair within 6 weeks leads to significant functional improvements and high patient satisfaction at 2 years. Understanding the mechanism of injury and pre-operative activity levels can aid in setting realistic expectations. Early initiation of structured rehabilitation is critical to optimize recovery.

Conclusion

Acute proximal hamstring tendon repair results in meaningful clinical improvements and high satisfaction at 2 years. Patient and injury characteristics, along with post-operative care, influence outcomes and should inform pre-operative counseling.

References

1. Best et al. 2020 -- Factors Influencing Functional Outcomes After Proximal Hamstring Repair
2. Bowman et al. 2021 -- Demographics and Outcomes After Proximal Hamstring Repair
3. Perth Hamstring Assessment Tool Validation Study 2015