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.
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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引用次数: 0
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 of evidence III, Cohort Study.
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).
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