Returning to sports after surgical repair of acute proximal hamstring ruptures

Abstract

Purpose: Although the treatment of choice for acute proximal hamstring ruptures is now surgical repair, this technique is relatively new and requires further evaluation. Our hypothesis was that patients return to sports at the same level after surgical repair as before injury.

Methods: From 2002 to 2011, a prospective observational study including 34 patients, mean age 39.3 ± 11.4 years old underwent surgical repair of an acute proximal hamstring rupture. Surgical, rehabilitation and follow-up protocols were standardized. Mean follow-up was 27.2 ± 22.9 months and there were no lost to follow-up. The primary outcome was the level of activity on the UCLA and Tegner scores.

Results: The mean UCLA score was 9.1 ± 1.3 before injury and 8.7 ± 1.7 at the final follow-up (p = 0.03). The median Tegner activity level was 6 (range, 4-10) before injury and 6 (range, 3-10) at the final follow-up (p = 0.05). The two scores were correlated (r = 0.76, p = 0.00001). Patients returned to sports within a mean 5.7 ± 1.6 months, at the same level in 27 patients (79.4 %) and at a lower level in 7 patients (20.6 %). The average hamstring/quadriceps ratio at 240°/second was 54.7 ± 8.6 % which was positively correlated to the level of activity on the UCLA score (r = 0.49, n.s.). The level of satisfaction was related to their level of activity at the final follow-up (p = 0.03).

Conclusion: Although surgical repair of acute proximal hamstring ruptures has significantly improved the functional prognosis of patients it remains a serious condition that can compromise future sports activities.

Level of evidence: Case-control study, Level III.