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Systematic Review of Complications Associated With Proximal Hamstring Tendon Repair
Jonathan J Lawson1, Eliza A Abraham1, Casey M Imbergamo1
1MedStar Orthopaedic Institute, Union Memorial Hospital, Baltimore, Maryland, USA.
Insights
Proximal hamstring tendon repair has a 15.3% overall complication rate, with major issues like nerve injury occurring in 4.6% of cases. This systematic review details common complications to inform surgical decisions.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Research
- Surgical Outcomes Analysis
Background:
- Proximal hamstring tendon ruptures are increasingly recognized.
- Existing literature offers limited comprehensive analysis of complication profiles following surgical repair.
Purpose of the Study:
- To determine the overall incidence of complications after proximal hamstring tendon repair.
- To categorize and analyze the types of complications encountered.
Main Methods:
- Systematic review of English-language studies (evidence level 4 or higher).
- Data extraction on complications from 43 articles encompassing 2833 repairs.
- Quantitative synthesis comparing open and endoscopic approaches.
Main Results:
- Overall postoperative complication rate was 15.3% (433/2833).
- Major complications occurred at 4.6%, including sciatic nerve injury (1.7%) and reoperation (0.8%).
- Minor complications included nerve injury and pain (2.4%-2.2%).
Conclusions:
- Proximal hamstring tendon repair presents a significant overall complication rate of 15.3%.
- Major complications, such as nerve injury, represent 4.6% of cases, necessitating careful surgical consideration.
Background:
Although several complications of proximal hamstring tendon ruptures have been reported in the literature, few studies have comprehensively analyzed the complication profile of proximal hamstring tendon repair.
Purpose:
To identify the overall rate of complications following proximal hamstring tendon repair and to differentiate these complications into categories.
Study Design:
Systematic review; Level of evidence, 4.
Methods:
Included in this review were studies that examined surgical repair of proximal hamstring tendon ruptures; all studies were in English and had an evidence level of 4 or higher. No restrictions were made regarding publication date or methodological quality. Data regarding complications were extracted to calculate the overall complication rate as well as the rate of major and minor complications. A quantitative data synthesis was conducted using the chi-square test to compare the proportion of patients who experienced complications with the endoscopic versus open approach.
Results:
A total of 43 articles including 2833 proximal hamstring tendon repairs were identified. The overall postoperative complication rate was 15.3% (n = 433). The rate of major complications was 4.6%, including a 1.7% rate of sciatic nerve injury, 0.8% rate of venous thromboembolism, 0.8% reoperation rate, 0.8% rerupture rate, and 0.4% rate of deep infection. Minor complications included a 2.4% rate of posterior femoral cutaneous nerve injury, 2.3% rate of persistent hamstring myopathy, 2.2% rate of persistent sitting pain, 1.8% rate of peri-incisional numbness, 1.1% rate of superficial infection, and 0.8% rate of hematoma/seroma.
Conclusion:
Proximal hamstring tendon repair is associated with an overall complication rate of 15.3%, including a 4.6% rate of major complications.
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