nach oben

Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

01.03.2013 | Sports Medicine

Total proximal hamstring ruptures: clinical and MRI aspects including guidelines for postoperative rehabilitation

verfasst von: Carl M. Askling, George Koulouris, Tönu Saartok, Suzanne Werner, Thomas M. Best

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

The aim of this article is to provide a state-of-the-art review for treatment of acute, total proximal hamstring tendon ruptures. For total proximal hamstring tendon ruptures, early (<2–3 w) surgical refixation minimizes muscle atrophy and facilitates a somewhat predictable time course for healing and rehabilitation. A postoperative rehabilitation program is detailed that has been used by one physical therapist for the past 7 years on over 200 patients with surgical repair for total proximal hamstring tendon rupture. One re-rupture has occurred, 7 months after surgery, following the rehabilitation program described herein. The rehabilitation program, including avoidance of postoperative bracing, appears effective for total proximal hamstring ruptures. Early surgery together with a specific rehabilitation program appears to be the treatment of choice for timely and safe return to sport and an active lifestyle.

Level of evidence V.

Askling CM, Tengvar M, Saartok T et al (2007) Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med 35:197–206PubMedCrossRef

Askling CM, Tengvar M, Saartok T et al (2007) Acute first-time hamstring strains during slow-speed stretching: clinical, magnetic resonance imaging, and recovery characteristics. Am J Sports Med 35:1716–1724PubMedCrossRef

Askling CM, Nilsson J, Thorstensson A (2010) A new hamstring test to complement the common clinical examination before return to sport after injury. Knee Surg Sports Traumatol Arthrosc 18:1798–1803PubMedCrossRef

Barrett T, Arthurs OJ (2010) Adductor magnus: a post-operative illustration of its dual nerve supply. Clin Anat 23:115–119PubMed

Benjamin M, Toumi H, Ralphs JR et al (2006) Where tendons and ligaments meet bone: attachment sites (‘entheses’) in relation to exercise and/or mechanical load. J Anat 208:471–490PubMedCrossRef

Best TM, Garrett WE Jr (1996) Hamstring strains: expediting return to play. Phys Sportsmed 24:37–44PubMedCrossRef

Birmingham P, Muller M, Wickiewicz T et al (2011) Functional outcome after repair of proximal hamstring avulsions. J Bone Joint Surg Am 93:1819–1826PubMedCrossRef

Brucker PU, Imhoff AB (2005) Functional assessment after acute and chronic complete ruptures of the proximal hamstring tendons. Knee Surg Sports Traumatol Arthrosc 13:411–418PubMedCrossRef

Carmichael J, Packham I, Trikha SP et al (2009) Avulsion of the proximal hamstring origin: surgical technique. J Bone Joint Surg Am 91(suppl 2):249–256PubMed

10.

Clark BB, Jaffe D, Henn F III, Lovering RM (2011) Evaluation and imaging of an untreated grade III hamstring tear. Clin Orthop Relat Res 469:3248–3252PubMedCrossRef

11.

Clarke AW, Connell DA (2009) Case report: bilateral ischial stress fractures in an elite tennis player. Skeletal Radiol 38:711–714PubMedCrossRef

12.

Cohen S, Bradley J (2007) Acute proximal hamstring rupture. J Am Acad Orthop Surg 15:350–355PubMed

13.

Connell DA, Schneider-Kolsky ME, Hoving JL et al (2004) Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries. AJR Am J Roentgenol 183:975–984PubMed

14.

De Smet AA, Best TM (2000) MR imaging of the distribution and location of acute hamstring injuries in athletes. AJR Am J Roentgenol 174:393–399PubMed

15.

Ekstrand J, Hagglund M, Walden M (2011) Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med 45:553–558PubMedCrossRef

16.

Ekstrand J, Healy JC, Waldén M et al (2012) Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play. Br J Sports Med 46:112–117PubMedCrossRef

17.

Floor S, van der Veen AH (2010) Two patients with a complete proximal rupture of the hamstring. Arch Orthop Trauma Surg 130:523–526PubMedCrossRef

18.

Folsom GJ, Larson CM (2008) Surgical treatment of acute versus chronic complete proximal hamstring ruptures. Am J Sports Med 36:104–109PubMedCrossRef

19.

Gibbs NJ, Cross TM, Cameron M et al (2004) The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players. J Sci Med Sport 7:248–258PubMedCrossRef

20.

Gidwani S, Bircher MD (2007) Avulsion injuries of the hamstring origin—a series of 12 patients and management algorithm. Ann R Coll Surg Engl 89:394–399PubMedCrossRef

21.

Hamersly SF, Schrader M (2009) Postoperative rehabilitation of proximal hamstring tendon tears. Oper Tech Sports Med 17:219–224CrossRef

22.

Harris JD, Griesser MJ, Best TM, Ellis TJ (2011) Treatment of proximal hamstring ruptures—a systematic review. Int J Sports Med 32:490–495PubMedCrossRef

23.

Heiderscheit B, Sherry MA, Silder A, Chumanov ES, Thelen DG (2010) Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther 40:67–81PubMed

24.

Herneth AM, Trattnig S, Bader TR et al (2000) MR imaging of the ischiopubic synchondrosis. Magn Reson Imaging 18:519–524PubMedCrossRef

25.

Kirkland A, Garrison C, Singleton S, Rodrigo J, Boettner F, Stuckey S (2008) Surgical and therapeutic management of a complete proximal hamstring avulsion after failed conservative approach. J Orthop Sports Phys Ther 38:754–760PubMed

26.

Klingele KE, Sallay P (2002) Surgical repair of complete proximal hamstring tendon rupture. Am J Sports Med 30:742–747PubMed

27.

Konan S, Haddad F (2010) Successful return to high level sports following early surgical repair of complete tears of the proximal hamstring tendons. Int Orthop 34:119–123PubMedCrossRef

28.

Koulouris G, Connell D (2003) Evaluation of the hamstring muscle complex following acute injury. Skeletal Radiol 32:582–589PubMedCrossRef

29.

Koulouris G, Connell D (2005) Hamstring muscle complex: an imaging review. Radiographics 25:571–586PubMedCrossRef

30.

Koulouris G, Connell DA, Brukner P et al (2007) Magnetic resonance imaging parameters for assessing risk of recurrent hamstring injuries in elite athletes. Am J Sports Med 35:1500–1506PubMedCrossRef

31.

Kwak HY, Bae SW, Choi YS, Jang MS (2011) Early surgical repair of acute complete rupture of the proximal hamstring tendons. Clin Orthop Surg 3:249–253PubMedCrossRef

32.

Lempainen L, Sarimo J, Heikkilä J et al (2006) Surgical treatment of partial tears of the proximal origin of the hamstring muscles. Br J Sports Med 40:688–691PubMedCrossRef

33.

Lempainen L, Sarimo J, Orava S (2007) Recurrent and chronic complete ruptures of the proximal origin of the hamstring muscles repaired with fascia lata autograft augmentation. J Arth Rel Surgery 23(4):441–445

34.

Linklater JM, Hamilton B, Carmichael J et al (2010) Hamstring injuries: anatomy, imaging, and intervention. Semin Musculoskelet Radiol 14:131–161PubMedCrossRef

35.

Orava S, Kukala UM (1995) Rupture of the ischial origin of the hamstring muscles. Am J Sports Med 23(6):702–705PubMedCrossRef

36.

Peetrons P (2002) Ultrasound of muscles. Eur Radiol 12:35–43PubMedCrossRef

37.

Pomeranz SJ, Heidt RS Jr (1993) MR imaging in the prognostication of hamstring injury. Work in progress. Radiology 189:897–900PubMed

38.

Ripani M, Continenza MA, Cacchio A et al (2006) The ischiatic region: normal and MRI anatomy. J Sports Med Phys Fitness 46:468–475PubMed

39.

Sallay PI, Friedman RL, Coogan PG, Garrett WE (1996) Hamstring muscle injuries among water skiers: functional outcome and prevention. Am J Sports Med 24:130–136PubMedCrossRef

40.

Sallay PI, Ballard G, Hamersly S, Schrader M (2008) Subjective and functional outcomes following surgical repair of complete ruptures of the proximal hamstring tendons. Orthopedics 31:1092–1102PubMedCrossRef

41.

Sallay PI (2009) Diagnosis, classification, and management of acute proximal hamstring avulsion injuries. Op Tech Sports Med 17:196–204CrossRef

42.

Sarimo J, Lempainen L, Mattila K, Orava S (2008) Complete proximal hamstring avulsions. A series of 41 patients with operative treatment. Am J Sports Med 36:1110–1115PubMedCrossRef

43.

Schache AG, Koulouris G, Kofoed W et al (2008) Rupture of the conjoint tendon at the proximal musculotendinous junction of the biceps femoris long head: a case report. Knee Surg Sports Traumatol Arthrosc 16:797–802PubMedCrossRef

44.

Scillia A, Choo A, Milman E et al (2011) Snapping of the proximal hamstring origin: a rare cause of coxa saltans: a case report. J Bone Joint Surg Am 93:1251–1253CrossRef

45.

Sherry MA, Best TM (2004) A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther 34:116–125PubMed

46.

Silder A, Heiderscheit BC, Thelen DG, Enright T, Tuite MJ (2008) MR observations of long-term musculotendon remodeling following a hamstring strain injury. Skeletal Radiol 37:1101–1109PubMedCrossRef

47.

Slavotinek JP, Verrall GM, Fon GT (2002) Hamstring injury in athletes: using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition. Am J Roentgenol 179:1621–1628

48.

Stafford GH, Villar RN (2011) Ischiofemoral impingement. J Bone Joint Surg Br 93:1300–1302PubMedCrossRef

49.

Torriani M, Souto SC, Thomas BJ et al (2009) Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. Am J Roentgenol 193:186–190CrossRef

50.

Verrall GM, Slavotinek JP, Barnes PG et al (2001) Clinical risk factors for hamstring muscle strain injury: a prospective study with correlation of injury by magnetic resonance imaging. Br J Sports Med 35:435–439PubMedCrossRef

51.

Verrall GM, Slavotinek JP, Barnes PG et al (2003) Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain. Am J Sports Med 31:969–973PubMed

52.

Verrall GM, Slavotinek JP, Barnes PG et al (2006) Assessment of physical examination and magnetic resonance imaging findings of hamstring injury as predictors for recurrent injury. J Orthop Sports Phys Ther 36:215–224PubMed

53.

Wait A, Gaskill T, Sarwar Z et al (2011) Van neck disease: osteochondrosis of the ischiopubic synchondrosis. J Pediatr Orthop 31:520–524PubMedCrossRef

54.

Wood DG, Packham I, Trikha PS et al (2008) Avulsion of the proximal hamstring origin. J Bone Joint Surg Am 90:2365–2374PubMedCrossRef

55.

Yamamoto T, Akisue T, Nakatani T et al (2004) Apophysitis of the ischial tuberosity mimicking a neoplasm on magnetic resonance imaging. Skeletal Radiol 33:737–740PubMedCrossRef

56.

Zissen MH, Wallace G, Stevens KJ et al (2010) High hamstring tendinopathy: MRI and ultrasound imaging and therapeutic efficacy of percutaneous corticosteroid injection. Am J Roentgenol 195:993–998CrossRef

Titel: Total proximal hamstring ruptures: clinical and MRI aspects including guidelines for postoperative rehabilitation
verfasst von: Carl M. Askling
George Koulouris
Tönu Saartok
Suzanne Werner
Thomas M. Best
Publikationsdatum: 01.03.2013
Verlag: Springer-Verlag
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 3/2013
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-2311-0

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2013

Autologous chondrocyte implantation in children and adolescents

Management of knee injuries: consensus-based indications from a large community of orthopaedic surgeons

Meniscus root refixation technique using a modified Mason–Allen stitch

Symptomatic mucoid degeneration of the anterior cruciate ligament

The degree of articular depression as a predictor of soft-tissue injuries in tibial plateau fracture