Background: Operative repair of partial proximal hamstring avulsions has been shown to improve pain and function at short- and midterm follow-up. Long-term outcomes have not yet been reported. Furthermore, it is unknown whether greater tendon involvement (ie, tendon number) in partial tears affects clinical outcomes. Hypothesis: Hamstring function and patient satisfaction would remain stable over time at minimum 5-year and mean 10-year follow-up, with no differences in outcomes when comparing isolated and combined tendon involvement. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent surgical repair of partial proximal hamstring avulsions refractory to nonoperative measures were included. Patient-reported outcome measures were completed and included the Lower Extremity Functional Score (LEFS), Marx Activity Rating Scale, custom LEFS, custom Marx, and total proximal hamstring score. Patient satisfaction, return to play, current sport participation, subjective strength, and postoperative complications were also recorded. Long-term outcomes were compared with midterm outcomes. Outcomes of isolated (semimembranosus or conjoint tendon) versus combined (semimembranosus and conjoint tendon) tendon injuries were also compared. Results: A total of 53 patients (57 hamstrings) met the inclusion criteria at a mean follow-up of 10.1 years (range, 5.1-16.2 years). The mean Marx score was 8.0 (range, 0-16), the custom Marx score was 95% (range, 15%-100%), the LEFS and custom LEFS were 90% (range, 22%-100%) and 83% (range, 19%-100%), respectively, and total proximal hamstring score was 89% (range, 19%-100%). In total, 91% of patients were satisfied with surgery and 95% of patients returned to sport at a mean of 11 months after surgery. Current participation in sport was endorsed by 86% of patients. Hamstring strength >75% compared with the contralateral leg was reported in 88% of patients, with 58% of patients reporting equal strength (100%). No differences were found in comparing long-term (mean 10.7 years) to midterm (mean 6.2 years) follow-up with the exception of decreases in the Marx score from 12.0 to 8.5 and custom Marx score from 100% to 95%. One case (1.7%) required revision due to acute reinjury at 4 months postoperatively, with other complications including sitting pain, occasional posterior thigh cramping, and posterior thigh or foot paresthesia. Conclusion: Surgical repair of partial proximal hamstring avulsions refractory to nonoperative measures led to successful outcomes and high rates of return to activities with low complications at mean 10.1-year follow-up, with no differences in outcomes comparing isolated versus combined tendon involvement.

中文翻译：

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部分近端腘绳肌撕脱修复术的长期结果：平均 10 年随访


背景： 部分近端腘绳肌撕脱的手术修复已被证明可以改善短期和中期随访中的疼痛和功能。长期结局尚未报道。此外，尚不清楚部分撕裂中更大的肌腱受累 （即肌腱数量） 是否会影响临床结局。假设：腘绳肌功能和患者满意度将在至少 5 年和平均 10 年的随访中随着时间的推移保持稳定，在比较孤立和联合肌腱受累时，结果没有差异。研究设计：病例系列;证据水平，4.方法： 纳入接受非手术治疗难治性部分近端腘绳肌撕脱手术修复的患者。完成了患者报告的结果测量，包括下肢功能评分 （LEFS） 、 Marx 活动评定量表 、定制 LEFS、定制 Marx 和近端腘绳肌总分。还记录了患者满意度、重返赛场、当前运动参与、主观力量和术后并发症。将长期结局与中期结局进行比较。还比较了孤立性 （半膜肌或关节肌腱） 与联合 （半膜肌和关节肌腱） 肌腱损伤的结局。结果： 共有 53 例患者 （57 例腘绳肌） 在平均随访 10.1 年 （范围，5.1-16.2 年） 时符合纳入标准。平均 Marx 评分为 8.0 （范围，0-16），定制 Marx 评分为 95% （范围，15%-100%），LEFS 和定制 LEFS 分别为 90% （范围，22%-100%） 和 83% （范围，19%-100%），近端腘绳肌总评分为 89% （范围，19%-100%）。总的来说，91% 的患者对手术感到满意，95% 的患者在手术后平均 11 个月恢复运动。 86% 的患者认可目前参加体育运动。据报道>与对侧腿相比，88% 的患者腘绳肌力量为 75%，其中 58% 的患者报告力量相同 （100%）。在比较长期 （平均 10.7 年） 和中期 （平均 6.2 年） 随访时，除了 Marx 评分从 12.0 降至 8.5 和定制 Marx 评分从 100% 降至 95% 外，未发现差异。1 例 （1.7%） 因术后 4 个月急性再损伤需要翻修，其他并发症包括坐痛、偶有大腿后痉挛、大腿后部或足部感觉异常。结论： 手术修复非手术治疗难治性部分近端腘绳肌撕脱伤导致成功结局和高活动恢复率，平均 10.1 年随访时并发症率低，孤立肌腱受累与联合肌腱受累相比结局无差异。