Open Proximal Hamstring Repair Yields Comparable Outcomes in Patients Older and Younger Than 60 Years

To compare patient-reported outcome measures (PROMs) and return-to-sport rates following proximal hamstring repair between patients older than versus younger than 60.

A retrospective study was conducted with patients who have undergone proximal hamstring repair between October 2021 and February 2023. Patients with acute or chronic, partial, or complete proximal hamstring tears who underwent open surgical repair, completed preoperative and postoperative PROMS, and had a minimum follow-up of 24 months were included. PROMs included: Perth Hamstring Assessment Tool (PHAT); Lower Extremity Functional Scale (LEFS); Hip Outcome Score (HOS), including the Activities of Daily Living (ADL) and Sports subscales; and 12-Item Short Forms Survey Questionnaire (SF-12). Patients were stratified into 2 cohorts depending on age at time of surgery: those under versus those 60 years and older (U-60 and O-60, respectively). Univariate analysis was performed to compare cohort demographics and clinical outcomes.

Fifty-five of the 59 eligible patients met the inclusion requirements of the study. The U-60 cohort included 36 patients with a mean age of 49.3 (21.8-58.6) years and the O-60 cohort included 19 patients with a mean age of 66 (60.0-75.0) years. The mean follow-up time was 23.3 ± 0.44 months for the O-60 group and 23.4 ± 0.50 months for the U-60 group (P = .664). There were no significant differences between the O-60 and U-60 postoperative PROM scores (LEFS P = .346, HOS-ADL P = .389, HOS-Sports P = .648, PHAT P = .123, SF-12 mental component score P = .943, SF-12 physical component score P = .680). There were no significant differences between groups after disaggregating by sex (females: LEFS P = .273, HOS-ADL P = .278, HOS-Sports P = .963, PHAT P = .146; Males: LEFS P = .536, HOS-ADL P = .099, HOS-Sports P = .693, PHAT P = .446). There were no significant differences in achievement of cohort-specific minimal clinically important difference between the O-60 and U-60 groups for LEFS (P = .345), HOS-ADL (P = .067), HOS-Sports (P = .219), or PHAT (P = .426). These differences remained nonsignificant after disaggregating the data by sex. Forty-seven patients (85%) completed 2-year follow-up return-to-sport surveys. In the O-60 group, 100% (12/12) patients returned to sports, compared with 82.9% of patients (29/35) in the U-60 group (P = .315).

Proximal hamstring repair is a viable treatment option for the aging population and provides similar postoperative functional outcomes compared with younger patients.

Level III, retrospective comparative case series.