Proximal hamstring tendon avulsions: comparable clinical outcomes of operative and non-operative treatment at 1-year follow-up using a shared decision-making model

Autor: Anne D van der Made, Rolf W Peters, Claire Verheul, Frank F Smithuis, Gustaaf Reurink, Maarten H Moen, Johannes L Tol, Gino M M J Kerkhoffs
Přispěvatelé: Orthopedic Surgery and Sports Medicine, Graduate School, AMS - Musculoskeletal Health, AMS - Amsterdam Movement Sciences, Surgery, Radiology and Nuclear Medicine, AMS - Sports, AMS - Ageing & Vitality
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: British journal of sports medicine, 56(6):104588, 340-348
van der Made, A D, Peters, R W, Verheul, C, Smithuis, F F, Reurink, G, Moen, M H, Tol, J L & Kerkhoffs, G M M J 2022, ' Proximal hamstring tendon avulsions : comparable clinical outcomes of operative and non-operative treatment at 1-year follow-up using a shared decision-making model ', British journal of sports medicine, vol. 56, no. 6, 104588, pp. 340-348 . https://doi.org/10.1136/bjsports-2021-104588
British journal of sports medicine, 56(6):104588, 340-348. BMJ Publishing Group
ISSN: 1473-0480
0306-3674
DOI: 10.1136/bjsports-2021-104588
Popis: ObjectiveTo prospectively evaluate 1-year clinical and radiological outcomes after operative and non-operative treatment of proximal hamstring tendon avulsions.MethodsPatients with an MRI-confirmed proximal hamstring tendon avulsion were included. Operative or non-operative treatment was selected by a shared decision-making process. The primary outcome was the Perth Hamstring Assessment Tool (PHAT) score. Secondary outcome scores were Proximal Hamstring Injury Questionnaire, EQ-5D-3L, Tegner Activity Scale, return to sports, hamstring flexibility, isometric hamstring strength and MRI findings including proximal continuity.ResultsTwenty-six operative and 33 non-operative patients with a median age of 51 (IQR: 37–57) and 49 (IQR: 45–56) years were included. Median time between injury and initial visit was 12 (IQR 6–19) days for operative and 21 (IQR 12–48) days for non-operative patients (p=0.004). Baseline PHAT scores were significantly lower in the operative group (32±16 vs 45±17, p=0.003). There was no difference in mean PHAT score between groups at 1 year follow-up (80±19 vs 80±17, p=0.97). Mean PHAT score improved by 47 (95% CI 39 to 55, pConclusionIn a shared decision-making model of care, both operative and non-operative treatment of proximal hamstring tendon avulsions resulted in comparable clinical outcome at 1-year follow-up. Operative patients had lower pretreatment PHAT scores but improved substantially to reach comparable PHAT scores as non-operative patients. We recommend using this shared decision model of care until evidence-based indications in favour of either treatment option are available from high-level clinical trials.
Databáze: OpenAIRE
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