Improved outcomes of proximal hamstring avulsion surgery in patients both under and over 50 years, with greater gains in the younger group: A matched comparative study of the PHAS cohort

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-01-23 DOI:10.1002/ksa.12596

Nicolas Lefèvre, Mohamad K. Moussa, Pierre Alban Bouché, Eugénie Valentin, Antoine Gerometta, Frederic Khiami, Olivier Grimaud, Alain Meyer, Yoann Bohu, Alexandre Hardy

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Abstract

Purpose

To evaluate the functional outcomes of surgical treatment for proximal hamstring avulsion injuries in patients aged over 50 years and to compare the results across another matched group of patients under 50.

Methods

This was a retrospective analysis of prospectively collected data in a matched case-control design targeting patients with proximal hamstring avulsion injuries who underwent surgical treatment at a sports surgery referral centre. Patients over 50 years with complete avulsion or partial injury (>2 cm retraction) were included. Two age groups were formed (18–50 and over 50), matched by the following variables: gender, rupture type (complete or partial), injury chronicity (chronic: more than 4 weeks from the injury or acute) and the preinjury Tegner score. The primary outcome was the Parisian Hamstring Avulsion Score (PHAS), with secondary outcomes, including the Tegner Activity Scale, University of California, Los Angeles (scale) (UCLA) scale, return to sport and complication rates.

Results

The study included 298 patients, with a mean age of 41.8 (7.2) years for the younger group and 58.0 (5.7) years for the older group. The follow-up duration in the younger group, 4.7 years (3.2), was slightly longer than that of the older group, 4.1 years (2.5), (p < 0.001). At the last follow-up, significant improvements were observed in PHAS, UCLA and Tegner scores in both groups (p < 0.001) compared to preoperative scores. The differential gain was higher in the younger group in all three scores (p < 0.05). The rerupture rate was 8.1% in the younger group and 4.7% in the older group (p > 0.05), with no significant differences in complication and return to sports rates (p > 0.05).

Conclusion

This study shows that surgical treatment of proximal hamstring avulsion injuries is associated with significant improvements in functional outcomes in both younger and older patients, with greater magnitude of improvements in younger patients. Complication rates were similar between the age groups.

Level of Evidence

Level III, Cohort Study.

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50岁以下和50岁以上患者进行近端腘绳肌腱撕脱手术的预后改善，年轻组获益更大：一项匹配的PHAS队列比较研究。

目的：评估50岁以上患者近端腘绳肌腱撕脱伤手术治疗的功能结果，并比较另一组50岁以下患者的结果。方法：回顾性分析在匹配病例对照设计中前瞻性收集的数据，该设计针对在运动外科转诊中心接受手术治疗的腘绳肌腱近端撕脱伤患者。患者年龄超过50岁，完全性撕脱或部分损伤（bbb20 - 2cm内收）。分为18-50岁和50岁以上两个年龄组，根据以下变量进行匹配：性别、破裂类型（完全或部分）、损伤慢性（慢性：距损伤超过4周或急性）和损伤前Tegner评分。主要结果是巴黎腘绳肌腱撕脱评分（PHAS），次要结果包括Tegner活动量表、加州大学洛杉矶分校（UCLA）量表、恢复运动和并发症发生率。结果：研究纳入298例患者，年轻组平均年龄41.8（7.2）岁，老年组平均年龄58.0（5.7）岁。青壮年组随访时间为4.7年（3.2年），略长于老年组4.1年（2.5年），差异有统计学意义（p < 0.05），并发症及恢复运动率差异无统计学意义（p < 0.05）。结论：本研究表明，手术治疗近端腘绳肌腱撕脱伤与年轻和老年患者功能预后的显著改善相关，年轻患者的改善幅度更大。不同年龄组的并发症发生率相似。证据等级：证据等级III，队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).