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. 2022 Sep 1;10(9):23259671221119774.
doi: 10.1177/23259671221119774. eCollection 2022 Sep.

Open Repair of Complete Proximal Hamstring Avulsions in Workers' Compensation Patients

Emma E Johnson  1 , Joseph M Brutico  1 , Lasya Rangavajjula  1 , Yuwei Xia  1 , Ryan W Paul  1 , Peters Otlans  1 , Justin W Arner  2 , Sommer Hammoud  1 , James P Bradley  2 , Steven B Cohen  1
Affiliations

Open Repair of Complete Proximal Hamstring Avulsions in Workers' Compensation Patients

Emma E Johnson et al. Orthop J Sports Med. .

Abstract

Background: Several studies have reported excellent results after surgical repair of proximal hamstring avulsions. However, the effect on these patients of receiving workers' compensation has not yet been explored.

Hypothesis: Workers' compensation patients undergoing proximal hamstring repair of complete tears will have similar outcomes when compared with a matched control group of non-workers' compensation patients.

Study design: Cohort study; Level of evidence, 3.

Methods: Workers' compensation patients who underwent complete proximal hamstring avulsion open repair between 2010 and 2019 were identified (WC group). A control group was matched by age (±3 years), sex, and body mass index (BMI; ±3). Demographics and patient-reported outcome measures were compared, including standard and custom Marx activity rating scale (MARS), standard and custom lower extremity functional scale (LEFS), and visual analog scale (VAS) for pain. Rate and time to return to work were recorded.

Results: The WC group was composed of 20 patients (8 men, 12 women) with a mean age of 52.3 years and BMI of 32.4. The 20 matched controls (8 men, 12 women) who underwent repair had a mean age of 50.6 years and a mean BMI of 31.2. There was no difference between the groups regarding age (P = .924), sex (P > .999), or BMI (P = .330). The WC group reported similar mean MARS (3.3 vs 5.4; P = .174), custom MARS (87.5 vs 97.0; P = .215), and VAS pain (3.3 vs 3.8; P = .698) scores compared with controls. However, the WC group had significantly lower standard LEFS (69.1 vs 94.1; P < .001) and custom LEFS (62.3 vs 87.9; P < .001) scores, returned to work at a lower rate (70.0% vs 94.1%; P = .039), and required more time to return to work after repair (4.3 vs 3.5 months; P = .029) compared with controls.

Conclusion: Workers' compensation patients who underwent open proximal hamstring repair for complete avulsions experienced inferior patient-reported outcomes, required more time to return to work, and returned to work at a lower rate than a matched control group.

Keywords: avulsion; hamstring; tear; work; workers’ compensation.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: P.O. has received education payments from Liberty Surgical, Smith & Nephew, and Summit Surgical. J.W.A. has received grant support from Arthrex and DJO and hospitality payments from Smith & Nephew. S.H. has received education payments from Liberty Surgical and hospitality payments from Arthrex and Smith & Nephew. S.B.C. has received education payments from Liberty Surgical and consulting fees from Zimmer Biomet. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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References

    1. Árnason Á, Gudmundsson Á, Dahl HA, Jóhannsson E. Soccer injuries in Iceland. Scand J Med Sci Sports. 2007;6(1):40–45. doi:10.1111/j.1600-0838.1996.tb00069.x - PubMed
    1. Arner JW, Freiman H, Mauro CS, Bradley JP. Functional results and outcomes after repair of partial proximal hamstring avulsions at midterm follow-up. Am J Sports Med. 2019;47(14):3436–3443. doi:10.1177/0363546519879117 - PubMed
    1. Beltran L, Ghazikhanian V, Padron M, Beltran J. The proximal hamstring muscle-tendon-bone unit: a review of the normal anatomy, biomechanics, and pathophysiology. Eur J Radiol. 2012;81(12):3772–3779. doi:10.1016/j.ejrad.2011.03.099 - PubMed
    1. Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999;79(4):371–383. - PubMed
    1. Birmingham P, Muller M, Wickiewicz T, Cavanaugh J, Rodeo S, Warren R. Functional outcome after repair of proximal hamstring avulsions. J Bone Joint Surg. 2011;93(19):1819–1826. doi:10.2106/JBJS.J.01372 - PubMed

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