دورية أكاديمية

Reconstruction of a Chronic, Retracted Proximal Hamstring Rupture Using Achilles Tendon Allograft

التفاصيل البيبلوغرافية
العنوان: Reconstruction of a Chronic, Retracted Proximal Hamstring Rupture Using Achilles Tendon Allograft
المؤلفون: David R. Swanson MD, MS, Sophie M. Nemec BS, Julie Winn PA-C, Hervey L. Kimball MD, Suzanne L. Miller MD
المصدر: Video Journal of Sports Medicine, Vol 4 (2024)
بيانات النشر: SAGE Publishing, 2024.
سنة النشر: 2024
المجموعة: LCC:Sports medicine
LCC:Orthopedic surgery
مصطلحات موضوعية: Sports medicine, RC1200-1245, Orthopedic surgery, RD701-811
الوصف: Background: Chronic, retracted proximal hamstring ruptures are a challenging problem and can be a significant cause of pain and disability if left untreated. Allograft augmentation is a viable surgical option with good clinical outcomes. Indications: Indications are symptomatic patients with chronic hamstring ruptures unable to be primarily repaired. Patients typically present with pain, instability, or lack of push of strength. Technique Description: An L-shaped extensile incision is made at the level of the gluteal crease. The gluteus maximus is retracted proximally. The sciatic nerve is identified, neurolysed, and tagged. Following the release of adhesions of the native tendon and confirmation of the inability to complete a primary repair, the Achilles tendon allograft is prepared. The allograft is incorporated with the native tendon and the subsequent hamstring construct is fixed and reduced to the ischial tuberosity with suture anchors. After copious irrigation, the incision is closed with Monocryl and Dermabond (Johnson and Johnson) and a sterile dressing is applied. The patient is placed in a hip brace locked in extension. Results: In a study by Rust et al, examining 72 patients with proximal hamstring ruptures, patients who underwent allograft reconstruction reported activities of daily living and postoperative sports activity equal to those of chronic repair, and inferior to those of acute repair. However, there were no significant differences between groups for patient-reported outcomes among acute and chronic repairs and allograft reconstruction. Moreover, a systematic review, by Van Der Made et al, published in the American Journal of Sports Medicine , included 13 studies that found that Achilles allograft repair for delayed proximal hamstring repair results in outcomes comparable to acute primary repair. Discussion/Conclusion: Although the literature on chronic proximal hamstring repair is fairly limited, studies have shown that proximal hamstring repair with allograft augmentation can be favorable in symptomatic patients. Allograft augmentation for chronic, retracted proximal hamstring ruptures provides increased functional outcomes in comparison with nonoperative management. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2635-0254
26350254
العلاقة: https://doaj.org/toc/2635-0254Test
DOI: 10.1177/26350254231188982
الوصول الحر: https://doaj.org/article/e31d69cc5bba4a2d870ca839b57016e2Test
رقم الانضمام: edsdoj.31d69cc5bba4a2d870ca839b57016e2
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:26350254
DOI:10.1177/26350254231188982