Treatment of proximal hamstring ruptures : a systematic review
Deutscher übersetzter Titel: | Behandlung der proximalen Muskelruptur der ischiokruralen Muskulatur : eine systematische Literaturübersicht |
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Autor: | Harris, Joshua D.; Giesser, M.J.; Best, T.M.; Ellis, T.J. |
Erschienen in: | International journal of sports medicine |
Veröffentlicht: | 32 (2011), 7, S. 490-495, Lit. |
Format: | Literatur (SPOLIT) |
Publikationstyp: | Zeitschriftenartikel |
Medienart: | Gedruckte Ressource Elektronische Ressource (online) |
Sprache: | Englisch |
ISSN: | 0172-4622, 1439-3964 |
DOI: | 10.1055/s-0031-1273753 |
Schlagworte: | |
Online Zugang: | |
Erfassungsnummer: | PU201110008899 |
Quelle: | BISp |
Abstract
Proximal hamstring ruptures are increasingly treated surgically, despite little high-level supporting evidence. We sought to determine whether there are differences in clinical outcome after surgical vs. non-surgical treatment of proximal hamstring tendinous avulsions/ruptures and acute vs. chronic surgical repair of tendinous avulsions. Multiple medical databases were searched for Level I-IV evidence. 18 studies were included. 298 subjects (300 proximal hamstring injuries) were analyzed with mean age of 39.7 years. 286 injuries were managed with surgical repair vs. 14 non-operative. 95 surgical cases were performed within 4 weeks of the injury (acute), while 191 were performed beyond 4 weeks (chronic). 292 injuries were tendinous avulsions while 8 were bony tuberosity avulsions. Surgical repair resulted in significantly (p<0.05) better subjective outcomes, greater rate of return to pre-injury level of sport, and greater strength/endurance than non-surgical management. Similarly, acute surgical repair had significantly better patient satisfaction, subjective outcomes, pain relief, strength/endurance, and higher rate of return to pre-injury level of sport than chronic repair (p<0.001) with reduced risk of complications and re-rupture (p<0.05). Chronic surgical repair also improves outcomes, strength and endurance, and return-to-sport, but not as well as acute repair. Non-operative treatment results in reduced patient satisfaction, with significantly lower rates of return to pre-injury level of sport and reduced hamstring muscle strength. Verf.-Referat