From the Department of Orthopaedic Surgery, University of Pittsburgh (Dr. Arner and Dr. McClincy), and Burke and Bradley Orthopedics, University of Pittsburgh Medical Center, UPMC St. Margaret (Dr. Bradley), Pittsburgh, PA.
J Am Acad Orthop Surg. 2019 Dec 1;27(23):868-877. doi: 10.5435/JAAOS-D-18-00741.
Hamstring injuries are common in athletes and can cause notable disability. They can be separated based on proximal, muscle belly, and distal injuries, with proximal and distal injuries more commonly requiring surgical intervention. Most injuries do not require acute MRI; however, MRI is useful in proximal and distal injuries as well as muscle belly tears that fail to respond to nonsurgical treatment. Acute repair of proximal avulsions, both partial and complete, result in successful outcomes, whereas chronic complete repairs are more difficult and less reliable. Muscle belly injuries have predictable outcomes but recurrence is common. Nonsurgical treatments focus on eccentric strengthening with the possible addition of low WBC platelet-rich plasma, which may have the potential to hasten recovery and decrease re-rupture. Distal injuries are relatively rare but may require surgical intervention. Hamstring reinjury is common, making continuation of preventive therapies after return to sport essential. Future research with larger sample sizes are required to determine how to decrease injury and reinjury rates, to evaluate the efficacy of platelet-rich plasma and to determine other treatments that may accelerate recovery after injury.
腘绳肌损伤在运动员中很常见，可导致明显的残疾。它们可以根据近端、肌腹和远端损伤进行区分，近端和远端损伤更常需要手术干预。大多数损伤不需要急性 MRI；然而，MRI 在近端和远端损伤以及对非手术治疗无反应的肌腹撕裂中很有用。急性修复近端撕脱伤，无论是部分还是完全的，都会产生成功的结果，而慢性完全修复则更困难且不太可靠。肌腹损伤的结果可预测，但复发很常见。非手术治疗侧重于离心强化，可能需要添加低白细胞血小板丰富的血浆，这可能有潜力加速恢复并减少再破裂。远端损伤相对较少见，但可能需要手术干预。腘绳肌再损伤很常见，因此在重返运动后继续进行预防治疗至关重要。需要进行更大样本量的未来研究，以确定如何降低损伤和再损伤的发生率，评估血小板丰富的血浆的疗效，并确定其他可能加速损伤后恢复的治疗方法。
