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Nationwide Database Analysis Shows Proximal Hamstring Repair in Adult Patients Is Associated With Lower Failure and
Sophia J Wang1, Ryan T Halvorson1, Joshua Chung1
1Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, U.S.A.
Purpose:
To compare reoperation and complication rates after proximal hamstring repair and reconstruction in a large nationwide sample.
Methods:
This retrospective cross-sectional study used a large nationwide insurance claims database with deidentified data (PearlDiver). Adult patients undergoing proximal hamstring repair (Current Procedural Terminology code 27385) or reconstruction (Current Procedural Terminology code 27386) with a diagnosis of proximal hamstring tear (International Classification of Diseases, Tenth Revision code S7631X) were included. A minimum 2-year follow-up was required. Rates of reoperation, emergency department (ED) utilization, and major complications (venous thromboembolism [VTE], sciatic nerve injury, and deep postoperative infection) were tabulated. Complication rates and ED utilization were compared using the Fisher exact test, and reoperations were assessed using Kaplan-Meier analysis.
Results:
A total of 2,813 patients (54.2% female) were included, with 2,656 undergoing proximal hamstring repair and 157 undergoing proximal hamstring reconstruction from 2015 to 2022. Proximal hamstring repair patients showed a lower 2-year reoperation rate compared with reconstruction patients (2.8% vs 5.7%, P = .038). The overall rates of VTE, sciatic nerve injury, and infection were 2.73%, 0.76%, and 0.91%, respectively. Patients undergoing repair showed lower rates of infection (0.69% vs 4.55%, P < .001) but had similar rates of sciatic nerve injury (0.81% vs 0.0%, P = .263) and VTE (2.62% vs 4.55%, P = .156) compared with patients undergoing reconstruction. There were no significant differences in rates of postoperative hospitalization or ED utilization.
Conclusions:
Patients undergoing proximal hamstring repair showed lower reoperation and postoperative infection rates compared with patients undergoing proximal hamstring reconstruction.
Level Of Evidence:
Level III, retrospective comparative case series.
