Surgical Treatment of Proximal Hamstring Avulsion Injuries Compared With Nonsurgical Treatment: A Matched Comparative Study With a Mean Follow-up of >4 Years From the Proximal Hamstring Avulsion Surgery Cohort Study.

backgroundSurgical outcomes for proximal hamstring avulsion injury (PHAI) are well documented, yet comparative analyses with nonsurgical approaches remain scarce. PURPOSE: To compare the functional outcomes between surgical and nonsurgical interventions for PHAI. STUDY

designCohort study; Level of evidence, 3.

methodsThis comparative study, conducted at a sports surgery center between January 2012 and July 2021, focused on patients with primary PHAI. The study was a retrospective analysis of prospectively collected data. Group selection involved utilizing propensity score matching to compare an arm of patients who were surgically treated (indications included patients with complete injury, patients with partial injury with >2 cm of retraction, and patients for whom 6 months of nonsurgical treatment failed) with another arm of patients who refused surgery. The primary outcome was evaluated using the Parisian Hamstring Avulsion Score (PHAS). The secondary outcomes included the Tegner Activity Scale (TAS) score; University of California, Los Angeles (UCLA) score; rate and quality of return to sport (RTS); and patient satisfaction.

resultsThe study included 32 patients (mean age, 55.8 years [SD, 8.4 years]) in the nonsurgical treatment arm and 95 patients in the surgical treatment arm (mean age, 53.4 years [SD, 7.7 years]) (

conclusionThis study demonstrated that surgical treatment of PHAI significantly enhances long-term functional scores, including the PHAS, TAS score, UCLA score, satisfaction, and RTS, at a mean follow-up of >4 years compared with nonsurgical treatment. REGISTRATION: NCT02906865 (ClinicalTrials.gov identifier).