■腿筋复合体损伤(PHCI)是职业运动员中常见的损伤,特别是那些参与枢轴接触运动的人。先前的研究表明,手术可以有效地恢复功能并允许运动员恢复运动(RTS),但影响RTS成功的因素还不太清楚。
■评估专业运动员PHCI手术治疗后的RTS能力,并确定RTS的有利预测因素。
■案例系列;证据级别,4.
■这项研究(2002-2022年)是针对在运动手术中心接受PHCI手术治疗的专业运动员进行的。这项研究的主要结果是RTS能力,根据运动员恢复到受伤前比赛水平的比率进行评估,时间延迟到RTS,以及RTS的质量,使用其在Tegner活动量表(TAS)和加利福尼亚大学等活动量表上的表现水平和得分进展来衡量,洛杉矶(UCLA)规模。“保持的表现”被定义为运动员恢复到相同的伤前活动水平(根据TAS和UCLA量表)并认为自己保持了表现。次要结果包括潜在的RTS预测因子和并发症发生率。该研究区分了2种类型的PHCI:近端腿筋肌腱撕脱伤(近端破裂,足迹空,或有“冰淇淋脱落阳性”)和完全近端无绳肌腱断裂(PHTR;近端断裂,没有空脚印,或有“负面的冰淇淋掉落标志”)。
■这项研究调查了64名职业运动员(平均年龄,27.3岁;82.8%男性)接受PHCI手术。RTS率为98.4%,78.1%的运动员在6.2个月时恢复到受伤前的比赛水平(SD,2.5个月)。12名(19%)患者在较差的比赛水平上恢复了运动,2人(3.1%)无法继续进行伤前运动。亚组分析显示RTS的变化基于运动类型,在手球和有分裂的运动(击剑,壁球,和escalade;100%)和足球(95.2%)。在单变量分析中,男性(危险比[HR],4.05;95%CI,1.45-11.3;P=.008),较高的伤前TAS评分(HR,1.27;95%CI,1.06-1.52;P=0.011),涉及半膜的损伤(HR,4.84;95%CI,2.31-10.2;P<.001)或关节肌腱(HR,3.12;95%CI,1.55-6.25;P=.001),和PHTR(HR,7.77;95%CI,3.54-17.0;P<.001)与较好的术后竞争水平显著相关。多变量分析确定了RTS的3个有利预测因子,男性的HR为2.91(95%CI,1.01-8.35;P=0.047),分离的半膜损伤为3.86(95%CI,1.78-8.37;P<.001),PHTR为5.18(95%CI,2.24-12.0;P<.001)。并发症发生率为4.7%。
■早期RTS的有利预测因素是男性,孤立的半膜损伤,和PHTR受伤。
■NCT02906865(ClinicalTrials.gov标识符)。
UNASSIGNED: Proximal hamstring complex injury (PHCI) is a common injury among professional athletes, particularly those participating in pivot contact sports. Previous studies have suggested that surgery can be effective in restoring function and allowing athletes to return to sport (RTS), but the factors influencing successful RTS have been less clear.
UNASSIGNED: To assess RTS capabilities after surgical treatment of PHCI in professional athletes and to identify favorable predictors of RTS.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: This
study (2002-2022) was conducted on professional athletes who underwent surgical treatment for PHCI at a sports surgery center. The primary outcome of the
study was the RTS capability, evaluated based on the rate of athletes\' return to their preinjury level of competition, time delay to RTS, and quality of RTS as measured using their level of performance and progression of scores on activity scales such as the Tegner Activity Scale (TAS) and University of California, Los Angeles (UCLA), scale. \"Maintained performance\" was defined as athletes returning to the same preinjury activity level (per the TAS and UCLA scale) and perceiving themselves to have maintained their performance. Secondary outcomes covered the potential RTS predictors and complication rate. The
study distinguished 2 types of PHCI: proximal hamstring tendon avulsion injury (proximal rupture with empty footprint, or having a \"positive dropped ice cream sign\") and complete proximal hamstring free tendon rupture (PHTR; proximal rupture without empty footprint, or having a \"negative dropped ice cream sign\").
UNASSIGNED: The
study examined 64 professional athletes (mean age, 27.3 years; 82.8% male) undergoing surgery for PHCI. The RTS rate was 98.4%, with 78.1% of the athletes returning to their preinjury level of competition at 6.2 months (SD, 2.5 months). Twelve (19%) patients had returned to sport at an inferior level of competition, and 2 (3.1%) were unable to continue in their preinjury sport. Subgroup analysis revealed variation in RTS based on sport type, with the highest rate of return to preinjury performance found in athletes in handball and sports with splits (fencing, squash, and escalade; 100%) and soccer (95.2%). In the univariate analysis, male sex (hazard ratio [HR], 4.05; 95% CI, 1.45-11.3; P = .008), higher preinjury TAS score (HR, 1.27; 95% CI, 1.06-1.52; P = .011), injury involving the semimembranosus (HR, 4.84; 95% CI, 2.31-10.2; P < .001) or conjoint tendon (HR, 3.12; 95% CI, 1.55-6.25; P = .001), and PHTR (HR, 7.77; 95% CI, 3.54-17.0; P < .001) were significantly associated with a better postoperative level of competition. Multivariate analysis identified 3 favorable predictors of RTS with HRs of 2.91 (95% CI, 1.01-8.35; P = .047) for male sex, 3.86 (95% CI, 1.78-8.37; P < .001) for isolated semimembranosus injury, and 5.18 (95% CI, 2.24-12.0; P < .001) for PHTR. The complication rate was 4.7%.
UNASSIGNED: Favorable predictors of early RTS were male sex, isolated semimembranosus injury, and PHTR injuries.
UNASSIGNED: NCT02906865 (ClinicalTrials.gov identifier).