Practice patterns for the treatment of acute proximal hamstring ruptures

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Injuries

Background:

• Proximal hamstring avulsion injuries are uncommon, leading to variable management strategies.
• There is a lack of consensus regarding surgical indications, operative techniques, and post-operative rehabilitation protocols.

Purpose of the Study:

• To survey surgeons managing proximal hamstring avulsion injuries.
• To identify current trends and disparities in the management of these injuries.

Main Methods:

• A 46-question cross-sectional survey was distributed electronically to orthopedic surgeons.
• The survey collected data on surgeon experience, diagnostic preferences, treatment patterns, and post-operative protocols.
• Invitations were sent to members of the American Orthopedic Society for Sports Medicine (AOSSM) and Arthroscopy Association of Canada (AAC).

Main Results:

• 108 surgeons completed the survey; 77% treat 1-5 injuries annually.
• MRI is the preferred diagnostic imaging modality.
• While 98% believe surgery has a role, only 50% of cases are operatively treated, with tendon involvement, retraction, and patient activity as key indications.

Conclusions:

• Significant disparities exist in the management of proximal hamstring avulsions.
• Lack of agreement on surgical indications, techniques, and rehabilitation protocols is evident.
• High rates of non-operative treatment and perceived poor outcomes warrant further investigation into objective management strategies.