Functional impairment after successful surgical reconstruction for proximal hamstring avulsion

Area of Science:

• Orthopedic surgery
• Sports medicine
• Rehabilitation science

Background:

• Surgical refixation for hamstring avulsions yields good outcomes.
• Existing post-operative evaluation scores are often non-specific, varied, and may overestimate results due to ceiling effects.
• A new, injury-specific assessment tool, the Perth Hamstring Assessment Tool (PHAT), has been developed to provide more realistic outcome data.

Purpose of the Study:

• To evaluate patients who underwent surgical refixation for hamstring avulsion injuries.
• To compare outcomes using previously utilized assessment tools and the new PHAT.
• To identify potential ceiling effects in outcome scoring.

Main Methods:

• Retrospective evaluation of surgically treated hamstring injuries.
• Utilized the PHAT, customized Lower Extremity Functional Scale (C-LEFS), and customized Marx score (C-Marx).
• Analyzed and compared scores, including potential ceiling effects and correlations between the different assessment tools.

Main Results:

• Sixty-four patients were enrolled; 49 (76%) were evaluated.
• Mean PHAT score was 74.1 (out of 100) after 28 months.
• High correlation was found between PHAT and C-LEFS (r=0.81), with lower correlations between PHAT and C-Marx (r=0.52), and C-LEFS and C-Marx (r=0.48).

Conclusions:

• Surgical intervention for hamstring avulsions results in good subjective functional outcomes across all assessed scores.
• The PHAT indicates that residual complaints after surgery are more prevalent than suggested by conventional scoring methods.
• Future research should combine injury-specific assessments like the PHAT with objective measurements for comprehensive patient evaluation and guidance.