Surgical Treatment of Acute Versus Chronic Complete Proximal Hamstring Ruptures: Results of a New Allograft Technique for Chronic Reconstructions

Minnesota Sports Medicine Orthopaedic Sports Medicine Fellowship Program and Twin Cities Orthopaedics, Eden Prairie, Minnesota

^* To whom correspondence should be addressed. E-mail: clars{at}med.unc.edu.

	Abstract

Background: Acute surgical repair of proximal hamstring ruptures has been shown to result in a high return to preinjury activity level.

Hypothesis: Achilles allograft reconstruction of chronic complete proximal hamstring ruptures results in improved function and strength that approaches that of acute surgical repairs.

Study Design: Cohort study; Level of evidence, 2.

Methods: Between 2002 and 2005, 26 patients underwent surgical treatment for complete proximal hamstring ruptures. Twenty-one were acute primary repairs. Five chronic ruptures were treated with Achilles allograft reconstruction with (n = 2) or without (n = 2) interference screw fixation or mobilization and primary repair (n = 1). Isokinetic strength testing was conducted postoperatively in 11 acute and 3 chronic cases, and a functional questionnaire was given at most recent follow-up.

Results: Subjective results for all patients at a mean follow-up of 20 months revealed good leg control in 96%, no pain in 80%, and return to sporting activities in 76%. Ninety-six percent of patients said they would have the procedure done again. With the isokinetic testing available at most recent follow-up, there was no significant difference in the mean hamstring strength deficits for the acute versus chronic groups tested at 60 deg/s (8% vs 21%, P = .295) and 180 deg/s (12% vs 2%, P = .294). Overall, there were 3 major adverse events and 5 patients with superficial wound drainage treated with antibiotics.

Conclusion: Surgical treatment of acute and chronic complete proximal hamstring ruptures can result in a high return to full activity. Reconstruction of chronic ruptures with Achilles allograft appears to restore function and strength comparable to acute repairs.