At mid- to long-term follow-up after proximal hamstring tendon avulsion; there was greater fatty infiltration, muscle atrophy and strength deficit in the hamstring muscles of the injured leg than in the uninjured leg

Journal of Orthopaedic Surgery and Research

Research Article

Mikael Skorpil¹  Kenneth B. Jonsson²  Carl Johan Hedbeck³  Elsa Pihl³  Olof Sköldenberg³ 

[1] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden;Unit of Orthopeadics, Department of Clinical Sciences at Danderyds Hospital, Karolinska Institutet, Ortopedmottagningen Danderyds Sjukhus, 182 88, Stockholm, Sweden;Danderyd University Hospital Corp, Stockholm, Sweden;

关键词: Magnetic resonance imaging;    Proximal Hamstring avulsion;    Muscle quality;    Fatty infiltration;    Strength;   

DOI  :  10.1186/s13018-023-03582-2

 received in 2022-12-30, accepted in 2023-02-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundProximal hamstring tendon avulsions (PHAs) may be treated nonoperatively or operatively. Little is known about the result of the injury, and its treatment, on the quality and function of the hamstring muscle after healing and rehabilitation. We hypothesized that the injured leg would have greater fatty infiltration and atrophy than the uninjured leg at follow-up and that these findings would correlate to muscle weakness.MethodsIn a cross-sectional cohort study, 48 patients treated for PHA, either operatively or nonoperatively, were re-examined 2–11 years post-treatment. We measured muscle strength with isokinetic strength tests, and muscle volume and fatty infiltration with MRI.Primary outcomes were hamstring muscle quality, quantified by outlining the cross-sectional area slice-by-slice, and the degree of fatty infiltration estimated using the Goutallier grading method. Secondary outcome was concentric isokinetic hamstring muscle strength measured using BioDex at 60°/sec and tendon attachment assessed on MRI. Comparisons with the outcomes of the uninjured leg were made.ResultsThe total hamstring muscle volume was on average reduced by 9% (SD ± 11%, p < 0.001) compared to that of the uninjured leg. Fatty infiltration was significantly more severe in the injured hamstrings than in the uninjured hamstrings (p < 0.001). This was also true when only analyzing operatively treated patients. The reduction in muscle volume and increase in fatty infiltration correlated significantly (r = 0.357, p = 0.013), and there was also a statistically significant correlation with muscle atrophy and reduction in isokinetic strength (r = 494, p < 0.001).ConclusionPHA injuries result in fatty infiltration and muscle atrophy and the muscle quality impairment correlates with residual muscle weakness.

【 授权许可】

CC BY   
© The Author(s) 2023

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