Reattachment of the proximal hamstring origin: outcome in patients with partial and complete tears

Abstract

To assess the subjective and functional outcome in complete and partial injuries, both acute and chronic. One hundred and thirty-two consecutive proximal hamstring reattachments were performed by a single surgeon between 1999 and 2009. The mean age at the time of operation was 42.5 years (SD 12.2), the mean duration of follow-up was 53.8 months (SD 19.5), and all patients with a minimum 2-year follow-up were included in the study. Patients were reviewed independently. Functional outcome was evaluated using quantitative assessments of pre-operative and postoperative hamstring strength and endurance, while subjective outcome was undertaken at the latest follow-up using a three-tier questionnaire. The most common cause of injury was waterskiing (29 patients). There were 96 complete injuries and 36 partial injuries. Overall, 112 of 132 patients rated their result as good/excellent, 91 had returned to their pre-injury level of sporting activity, and 114 said that they would undergo surgery again. Mean postoperative hamstring strength was 83 %, and mean hamstring endurance was 108 % compared to the contralateral limb. Patients with complete injuries and those operated and those operated on acutely (<6 weeks) were more likely to have a good/excellent result. There was no significant correlation between time to repair, type of injury (partial vs. complete) and functional outcome. Good to excellent results can be expected in the majority of patients, following surgical reattachment. Surgery is well tolerated with the vast majority of patients, reporting that they would undergo surgery again. IV.