Clinical outcome following surgical and conservative treatment of proximal hamstring avulsions

BACKGROUND

Hamstring injuries are common in the athletic population. The severity of these injuries can vary considerably: from mild injuries to a complete three tendon rupture (avulsion) with retraction of the muscles. Total avulsion of the proximal tendons, typically occurring as a result of forced hip flexion and knee extension, is less common, but can result in significant disability for patients regarding sports activity. Proximal hamstring ruptures can be treated conservatively, but are increasingly treated surgically by reattachment of the hamstring tendon to the ischial tuberosity. Present studies reporting clinical outcome following surgical treatment are of low methodological quality and very few conservatively managed cases have been published. Therefore, there is lack of consensus on optimal treatment, and indication for surgical repair. Furthermore, the outcome of conservative versus operative treatment has never been compared in the literature using the same rehabilitation protocol and outcome measures.

OBJECTIVE

The purpose of this study is to determine clinical outcome following conservative or operative treatment of acute proximal hamstring tendon avulsions during a one year follow-up.