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Acute Proximal Hamstring Tears Can be Defined Using an Imaged-Based Classification.

Julianne M Forlizzi¹, Christopher R Nacca¹, Sarav S Shah¹

¹New England Baptist Hospital, Boston, Massachusetts, U.S.A.

Arthroscopy, Sports Medicine, and Rehabilitation

|May 2, 2022

Summary

This summary is machine-generated.

A new MRI-based classification system for proximal hamstring tears demonstrates excellent reliability. Surgical treatment improved patient outcomes, particularly for complete tears with significant retraction.

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Area of Science:

Orthopedic Surgery
Musculoskeletal Radiology
Sports Medicine

Background:

Proximal hamstring tears are common injuries in athletes and active individuals.
Current classification systems lack clinical utility and prognostic value.
Standardized classification is needed for consistent diagnosis and treatment planning.

Purpose of the Study:

To develop a reliable and clinically meaningful classification system for proximal hamstring tears based on MRI findings.
To evaluate patient outcomes associated with different tear subtypes and treatment modalities.

Main Methods:

Retrospective review of 114 patients with proximal hamstring tears (2012-2019).
Tears classified into Type 1 (partial), Type 2 (complete single-tendon), and Type 3 (>2 cm retraction) based on MRI.
Analysis of patient demographics, Hip Outcome Score (HOS-ADL), and patient satisfaction.
Comparison of outcomes between surgical and non-surgical management.

Main Results:

A novel MRI-based classification system (Type 1, 2, 3) was developed with excellent intra- and inter-observer reliability (Kappa > 0.9).
Type 3 tears (>2 cm retraction) were most common (50.9%).
Operatively treated patients showed significantly higher HOS-ADL scores (95% vs. 81.86%) and patient satisfaction (93.4% vs. 44.7%) compared to non-operative management.
Body mass index predicted poor outcomes in Type 3 tears.

Conclusions:

The proposed MRI classification system for proximal hamstring tears is reliable and clinically applicable.
Surgical intervention is associated with improved functional outcomes and patient satisfaction, especially for severe tears.
This classification aids in predicting outcomes and guiding treatment decisions for proximal hamstring injuries.