University Hospitals of Leicester, Leicester, England, UK.
South Metropolitan Health Service, Perth, WA, Australia.
Knee Surg Sports Traumatol Arthrosc. 2023 Oct;31(10):4601-4606. doi: 10.1007/s00167-023-07477-x. Epub 2023 Jul 10.
The purpose of this study was to assess the post-operative return to sport and re-injury rates following surgical repair of acute, first-time, high-grade intramuscular hamstring tendon injuries in high level athletes.
Patients were identified using the databases of two sports surgeons. Once patients were identified their clinical notes and imaging were reviewed to confirm that all patients had injuries to the intramuscular portion of the distal aspect of the proximal biceps femoris tendon. All imaging was reviewed by an experienced musculoskeletal radiologist to confirm diagnosis. Surgery for such injuries was indicated in high-level athletes presenting with acute hamstring injuries. All patients were operated on within 4 weeks. Outcomes included Tegner scores, return to sport, Lower Extremity Functional Score (LEFS), current hamstring symptoms and complications including re-injury.
Eleven injuries (10 patients) were included in the study. All patients were male and Australian Rules Football players. Six patients were professional athletes and 4 semi-professional athletes. Median age was 24.5 (range 21-29) and median follow-up period was 33.7 months (range; 16-65). 91% were British Athletic Muscle Injury Classification (BAMIC) 3c and 9% were BAMIC 4c. 91% were classed as MR2 and 9% as MR3 on the simplified four-grade injury classification. Athletes achieved return to play (RTP) at an average of 3.1 months (SD 1.0) post repair. All but one patient achieved a Tegner score equal to pre-injury levels. Maximum LEFS was achieved by all patients. Minor pain scores (all with VAS < 1/10) on sciatic and functional stretch were recorded in 36% and 27% of patients respectively, with subtle neural symptoms (9%) and subjective tightness (36%) also noted. There were no surgical complications in our patient cohort. No patients had a re-injury or re-operation.
Surgical repair of high-grade intramuscular tendon injuries of the biceps femoris hamstring muscle in athletes resulted in high levels of return to pre-injury sporting levels and no re-injuries. The intra-muscular tendon should be scrutinized when assessing hamstring injuries in elite sport and offer surgery in high-grade cases.
IV.
本研究旨在评估高水平运动员急性初次高发级别的股二头肌肌内型腘绳肌腱损伤的术后重返运动和再损伤率。
通过两位运动外科医生的数据库确定患者。一旦确定了患者，就会查阅他们的临床记录和影像学检查结果以确认所有患者都有腘绳肌腱近端股二头肌内侧面的损伤。所有影像学检查均由经验丰富的肌肉骨骼放射科医生进行审查以确认诊断。对于出现急性腘绳肌损伤的高水平运动员，需要进行手术。所有患者均在 4 周内进行手术。结果包括 Tegner 评分、重返运动、下肢功能评分（LEFS）、当前腘绳肌症状和并发症，包括再损伤。
研究纳入了 11 例（10 名患者）损伤。所有患者均为男性且为澳大利亚足球运动员。6 名患者为职业运动员，4 名为半职业运动员。中位年龄为 24.5 岁（范围 21-29 岁），中位随访时间为 33.7 个月（范围 16-65 个月）。91%为英国运动医学肌肉损伤分类（BAMIC）3c 型，9%为 BAMIC 4c 型。91%为简化四级损伤分类的 MR2 型，9%为 MR3 型。运动员在修复后平均 3.1 个月（SD 1.0）即可重返运动。除 1 名患者外，所有患者均达到与受伤前相同的 Tegner 评分。所有患者均达到最大 LEFS 评分。分别有 36%和 27%的患者记录到轻微的坐骨神经痛和功能拉伸时的疼痛评分（均为 VAS<1/10），9%的患者存在轻微神经症状，36%的患者存在主观紧张感。在我们的患者队列中，没有手术并发症。没有患者发生再损伤或再次手术。
在运动员中，对高发级别的股二头肌肌内型腘绳肌腱损伤进行手术修复，可使患者恢复到受伤前的运动水平，且不会再发生损伤。在评估精英运动员的腘绳肌损伤时，应仔细检查肌内肌腱，并对高发级别的病例进行手术治疗。
IV。
