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慢性部分和全层近端腘绳肌腱撕裂的开放式和内镜修复的结果:一项至少 2 年随访的多中心研究。

Outcomes of Open and Endoscopic Repairs of Chronic Partial- and Full-Thickness Proximal Hamstring Tendon Tears: A Multicenter Study With Minimum 2-Year Follow-up.

机构信息

Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, USA.

American Hip Institute Research Foundation, Chicago, Illinois, USA.

出版信息

Am J Sports Med. 2021 Mar;49(3):721-728. doi: 10.1177/0363546520981767. Epub 2021 Jan 15.

Abstract

BACKGROUND

The preponderance of literature on the repair of proximal hamstring tendon tears focuses on the acute phase (<4 weeks). As such, there is a paucity of data reporting on the outcomes of chronic proximal hamstring tears.

PURPOSE

To report minimum 2-year postoperative patient-reported outcome (PRO) scores, visual analog scale (VAS) for pain, and patient satisfaction from patients who underwent open or endoscopic repair of partial- and full-thickness chronic proximal hamstring tendon tears.

STUDY DESIGN

Case series study; Level of evidence, 4.

METHODS

Between April 2002 and May 2017, prospectively collected data from 3 tertiary care institutions were retrospectively reviewed for patients who underwent open and endoscopic repair of partial- and full-thickness chronic proximal hamstring tendon tears. Patients were included only if they had a chronic proximal hamstring tear (defined as ≥4 weeks from symptom onset to surgery). Patients were excluded if they had a tear treated <4 weeks after injury, underwent hamstring reconstruction, or claimed workers' compensation. Patients who reported minimum 2-year follow-up for VAS, patient satisfaction, and the following PROs had their outcomes analyzed: the modified Hip Harris Score, Non-arthritic Hip Score, iHOT-12 (International Hip Outcome Tool), and Hip Outcome Score-Sports Specific Subscale.

RESULTS

Fifty patients (34 females and 16 males) were included in this study. There were 19 endoscopic repairs and 31 open repairs. Within the cohort, 52.0% had a full-thickness tendon tear on magnetic resonance imaging, and 48.0% had a partial tear. Average follow-up time was 58.07 ± 37.27 months (mean ± SD; range, 24-220 months). The mean age and body mass index of the group were 46.13 ± 13 years and 25.43 ± 5.14. The average time from injury to surgery was 66.73 weeks (range, 5.14-215.14 weeks). Average postoperative PROs were as follows: modified Hip Harris Score, 91.94 ± 9.96; Non-arthritic Hip Score, 91.33 ± 9.99; iHOT-12, 87.17 ± 17.54; Hip Outcome Score-Sports Specific Subscale, 87.15 ± 18.10; and VAS, 1.16 ± 1.92. Patient satisfaction was 8.22 ± 1.20.

CONCLUSION

Patients who underwent open and endoscopic repairs for chronic partial- and full-thickness proximal hamstring tendon tears reported high PROs and satisfaction at a minimum 2-year follow-up with low rates of complications.

摘要

背景

大量关于近端腘绳肌腱撕裂修复的文献主要集中在急性期(<4 周)。因此,关于慢性近端腘绳肌腱撕裂的结果报告数据很少。

目的

报告接受开放式或内镜式部分和全层慢性近端腘绳肌腱撕裂修复的患者至少 2 年的术后患者报告的结局(PRO)评分、疼痛视觉模拟量表(VAS)和患者满意度。

研究设计

病例系列研究;证据水平,4 级。

方法

2002 年 4 月至 2017 年 5 月,对 3 家三级医疗机构前瞻性收集的数据进行回顾性分析,纳入接受开放式和内镜式部分和全层慢性近端腘绳肌腱撕裂修复的患者。仅纳入慢性近端腘绳肌腱撕裂(定义为症状发作至手术≥4 周)的患者。如果患者接受的是<4 周后受伤的治疗、接受了腘绳肌重建或声称工人补偿的,则排除在外。报告至少 2 年 VAS、患者满意度和以下 PRO 随访的患者(改良髋关节评分、非关节炎髋关节评分、iHOT-12(国际髋关节结果工具)和髋关节结果评分-运动特定亚量表)的结果进行了分析。

结果

本研究纳入了 50 名患者(34 名女性和 16 名男性)。其中 19 例行内镜修复,31 例行开放修复。在队列中,52.0%的患者在磁共振成像上显示全层肌腱撕裂,48.0%的患者显示部分撕裂。平均随访时间为 58.07±37.27 个月(均数±标准差;范围,24-220 个月)。该组的平均年龄和体重指数分别为 46.13±13 岁和 25.43±5.14。从受伤到手术的平均时间为 66.73 周(范围,5.14-215.14 周)。平均术后 PRO 结果如下:改良髋关节评分,91.94±9.96;非关节炎髋关节评分,91.33±9.99;iHOT-12,87.17±17.54;髋关节结果评分-运动特定亚量表,87.15±18.10;VAS,1.16±1.92。患者满意度为 8.22±1.20。

结论

接受开放式和内镜式部分和全层慢性近端腘绳肌腱撕裂修复的患者,至少在 2 年的随访中报告了较高的 PRO 和满意度,且并发症发生率较低。

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