School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.
Queensland X-Ray, Brisbane, QLD, Australia.
Scand J Med Sci Sports. 2020 Jun;30(6):1073-1082. doi: 10.1111/sms.13642. Epub 2020 Mar 11.
Recent literature has reported intramuscular tendon (IT) disruption is associated with longer return to play (RTP) following acute hamstring injury.
Investigate whether an increase in hamstring injury severity involving high-grade IT disruption and proximal injury location is associated with longer RTP times in elite Australian Rules Football (AFL) players.
Hamstring injury records and RTP times from one professional AFL club were obtained over six seasons. MRI of injuries was retrospectively reviewed by a musculo-skeletal radiologist blinded to RTP information. A simplified four-grade classification of acute hamstring injuries was developed based on IT disruption severity and proximodistal injury location. MR0 had no observable MRI tissue damage; MR1 involved muscle-tendon junction, myofascial and low-grade IT injuries; MR2 involved distal and/or single muscle high-grade IT injuries, and MR3 involved high-grade IT injuries of the proximal biceps femoris (BF) IT with concomitant injury to BF+ semitendinosus muscles.
Forty-one injuries were available for analysis. Median RTP times were as follows: MR0, 14 days; MR1, 21 days; MR2, 35 days; and MR3, 88 days. For MRI-positive injuries (MR1, MR2, MR3), there was a significant difference in the distributions of RTP, with increased injury severity associated with increased RTP times (P < .001). The distributions of RTP were significantly different between MR1 vs MR2 (P = .008), MR1 vs MR3 (P = .002), and MR2 vs MR3 (P = .012).
In elite AFL players, acute hamstring injuries with high-grade IT disruption identified on MRI were associated with increased times to RTP compared to injuries with low-grade or no IT disruption.
近期文献报道，肌内肌腱（IT）撕裂与急性腘绳肌损伤后重返赛场（RTP）时间延长有关。
探讨 MRI 显示 IT 高级别撕裂和近端损伤位置的腘绳肌损伤严重程度增加是否与精英澳式足球（AFL）运动员 RTP 时间延长相关。
获取一家职业 AFL 俱乐部在六个赛季中的腘绳肌损伤记录和 RTP 时间。由一名对 RTP 信息不知情的肌肉骨骼放射科医生对损伤的 MRI 进行回顾性审查。根据 IT 撕裂严重程度和远近端损伤位置，制定了一种急性腘绳肌损伤的简化四级分类。MR0 无明显 MRI 组织损伤；MR1 涉及肌肉-肌腱交界处、肌筋膜和低级别 IT 损伤；MR2 涉及远侧和/或单个肌肉的高级别 IT 损伤，以及 MR3 涉及近端股二头肌（BF）IT 的高级别 IT 损伤，同时伴有 BF+半腱肌损伤。
41 例损伤可用于分析。RTP 时间中位数如下：MR0，14 天；MR1，21 天；MR2，35 天；MR3，88 天。对于 MRI 阳性损伤（MR1、MR2、MR3），RTP 的分布存在显著差异，损伤严重程度增加与 RTP 时间延长相关（P<0.001）。MR1 与 MR2（P=0.008）、MR1 与 MR3（P=0.002）和 MR2 与 MR3（P=0.012）之间的 RTP 分布差异均具有统计学意义。
在精英 AFL 运动员中，与低级别或无 IT 撕裂的损伤相比，MRI 显示高级别 IT 撕裂的急性腘绳肌损伤与 RTP 时间延长相关。
