title: A prospective evaluation of proximal hamstring tendon avulsions: improved functional outcomes following surgical repair.
abstract: OBJECTIVE
  Avulsion of the proximal hamstring tendons is an uncommon injury. To date, few studies have prospectively evaluated outcomes of surgical repair. The aim of the present study is to review the functional outcomes of surgical repair of proximal hamstring tendon avulsions.
  
  
  METHODS
  This is a prospective series of 96 consecutive proximal hamstring surgical repairs in 94 patients, with a median age of 50 years and median follow-up of 33 months (range 12-58). Functional outcomes were assessed using the Perth Hamstring Assessment Tool (PHAT)-a validated scoring system for proximal hamstring injuries.
  
  
  RESULTS
  Significant improvements in functional outcomes were seen across all patients at 1-year follow-up. There was a mean PHAT score improvement of 34.7 points at the 1-year follow-up (p < 0.001, 95% CI 29.9-39.5). The SF-12 PCS scores showed a significant improvement at 1-year follow-up of 13.8 points (p < 0.001, 95% CI 10.7-16.9). These were maintained at final follow-up. Acute repairs had significantly higher improvement in PHAT score with acute patients improving a mean of 38.6 points (p < 0.001, 95% CI 32.0-44.3) and chronic patients only improving by a mean of 25.3 points (p < 0.001, 95% CI 18.2-33.3) at final follow-up.
  
  
  CONCLUSIONS
  This study establishes that surgical repair of proximal hamstring tendon ruptures leads to improved patient outcomes, in both acute and chronic repairs. Early surgical repair, however, achieves superior outcomes to late repair. These results suggest that surgeons should be operating on proximal hamstring avulsions, and preferably in the acute stage.
  
  
  METHODS
  II.
authors.affiliation: Department of Orthopaedic Surgery, Bunbury Regional Hospital, Bunbury, WA, Australia. blakeney@gmail.com.|Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. blakeney@gmail.com.
authors.forename: William G
authors.initials: WG
authors.lastname: Blakeney
authors.affiliation: Department of Orthopaedic Surgery, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Zilko
authors.affiliation: St John of God Murdoch Hospital, Murdoch, WA, Australia.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Edmonston
authors.affiliation: Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Schupp
authors.affiliation: Department of Orthopaedic Surgery, Mount Hospital, Perth, WA, Australia.|Perth Orthopaedic and Sports Medicine, Perth, WA, Australia.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Annear
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D000070632:Hamstring Tendons / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Functional outcomes; Proximal hamstring; Surgical repair