Operative vs non- operative treatment of hamstring ruptures
In this study an analysis was conducted, comparing the most appropriate management of proximal hamstring rupture through the use of operative versus non-operative means. In consideration of patient reported outcomes, functional measures and return to sport, the use of operative repair showed consistent improvements over non-operative management.
Proximal hamstring injuries, although rare, have been described as a devastating injury that when treated surgically reveal positive outcomes. However, comparison to a non-surgical intervention has been poorly defined. The authors retrospectively reviewed both groups including only those who received 12 months of follow-up. Both groups received a regimented rehabilitation program during the recovery phase and were subjected to the same qualitative and quantitative measures including LEFS, short form-12, strength testing, the single leg hop test, and return to sport tracking.
In evaluation of the LEFS outcome, the scores on average were higher for the operative group, however, the difference was declared non-significant. Mean single leg hop tests when compared to the uninjured leg and the SF-12 were also found non-significant however, isometric strength testing of the non-operative group was significant and defined as a clinically important weakness and isokinetic testing in the operative group revealed a 90% strength recovery compared to the uninjured side.
The authors conclude trends support operative management of proximal hamstring ruptures however, due to weaknesses in methodology and small sample size, further studies are needed before more robust inferences can be made.
> From: Shambaugh et al., Ortho J Sports Med 5 (2017-11-27 06:44:22) 2325967117738551(Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.