Musculotendinous injuries of the proximal biceps femoris: a prospective study of 64 patients with treated surgically
ESSKA Academy. Ayuob A. 11/08/19; 284452; epESMA-53 Topic: B4 - Direct tendon repair
Mr. Atif Ayuob
Mr. Atif Ayuob
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Musculotendinous injuries of the proximal biceps femoris: a prospective study of 64 patients with treated surgically

ePoster - epESMA-53

Topic: Sports Trauma

Ayuob A., Kayani B., Haddad F.
University College London Hospital, Trauma and Orthopaedics, London, United Kingdom

Introduction: Injuries to the hamstring complex most commonly involve the proximal musculotendinous junction of the long head of biceps femoris (MTJ-BFlh). Non-operative management of these injures is associated with high risk of recurrence.
Objective: To assess outcomes of the surgical management of acute MTJ-BFlh injuries as compared to non-operative treatment. Our working hypothesis is "Surgical repair of acute MT-BFlh injuries enables return to sporting activity with low risk of recurrence".
Aims: To ascertain if surgical intervention can provide a viable modality of treatment for musculo-tendinous junction tears of Biceps Femoris long head. Primary objective to assess if recurrence rates are reduced over two years post-surgery. Secondary outcomes include recuperation of muscle strength, flexibility, functional scores and patient satisfaction.
Methods: Sixty-four patients (42 males and 22 females) undergoing surgical repair of acute MTJ-BFlh injuries were included. Predefined outcomes were recorded at regular intervals after surgery. Mean follow-up time after surgery was 29.2 months (range, 24.0 months to 37.1 months).
Results: All study patients returned to their preinjury level of sporting activity. Mean time from surgical intervention to return to sporting activity was 13.4 ± 5.1 weeks. Three patients had re-injury at the operative site, which included one patient (1.6%) with MTJ-BFlh injury and two patients (3.2%) with myofascial tears. At 3 months after surgery, patients had improved mean passive straight leg raise (72.0° ± 11.4° vs 24.1° ± 6.8°, p< 0.001); increased mean isometric hamstring muscle strength at 0° (88.5% ± 10.4% vs 25.9% ± 8.9%, p< 0.001), 15° (89.5% ± 7.3% vs 41.2% ± 9.7%, p< 0.001) and 45° (93.9% ± 5.1% vs 63.4% ± 7.6%, p< 0.001), higher median lower extremity functional scores (72, IQR; 70-74 vs 30, IQR; 25-34, p< 0.001), and improved median Marx activity rating scores (12, IQR; 12-6 vs 6, IQR; 4-8, p< 0.001) compared to preoperative scores. High patient satisfaction and functional outcome scores were maintained at one year and two years following surgery.
Conclusion: Surgical repair of acute MT-BFlh injuries enables return to preinjury level of sporting function with low risk of recurrence at short-term follow-up.
Musculotendinous injuries of the proximal biceps femoris: a prospective study of 64 patients with treated surgically

ePoster - epESMA-53

Topic: Sports Trauma

Ayuob A., Kayani B., Haddad F.
University College London Hospital, Trauma and Orthopaedics, London, United Kingdom

Introduction: Injuries to the hamstring complex most commonly involve the proximal musculotendinous junction of the long head of biceps femoris (MTJ-BFlh). Non-operative management of these injures is associated with high risk of recurrence.
Objective: To assess outcomes of the surgical management of acute MTJ-BFlh injuries as compared to non-operative treatment. Our working hypothesis is "Surgical repair of acute MT-BFlh injuries enables return to sporting activity with low risk of recurrence".
Aims: To ascertain if surgical intervention can provide a viable modality of treatment for musculo-tendinous junction tears of Biceps Femoris long head. Primary objective to assess if recurrence rates are reduced over two years post-surgery. Secondary outcomes include recuperation of muscle strength, flexibility, functional scores and patient satisfaction.
Methods: Sixty-four patients (42 males and 22 females) undergoing surgical repair of acute MTJ-BFlh injuries were included. Predefined outcomes were recorded at regular intervals after surgery. Mean follow-up time after surgery was 29.2 months (range, 24.0 months to 37.1 months).
Results: All study patients returned to their preinjury level of sporting activity. Mean time from surgical intervention to return to sporting activity was 13.4 ± 5.1 weeks. Three patients had re-injury at the operative site, which included one patient (1.6%) with MTJ-BFlh injury and two patients (3.2%) with myofascial tears. At 3 months after surgery, patients had improved mean passive straight leg raise (72.0° ± 11.4° vs 24.1° ± 6.8°, p< 0.001); increased mean isometric hamstring muscle strength at 0° (88.5% ± 10.4% vs 25.9% ± 8.9%, p< 0.001), 15° (89.5% ± 7.3% vs 41.2% ± 9.7%, p< 0.001) and 45° (93.9% ± 5.1% vs 63.4% ± 7.6%, p< 0.001), higher median lower extremity functional scores (72, IQR; 70-74 vs 30, IQR; 25-34, p< 0.001), and improved median Marx activity rating scores (12, IQR; 12-6 vs 6, IQR; 4-8, p< 0.001) compared to preoperative scores. High patient satisfaction and functional outcome scores were maintained at one year and two years following surgery.
Conclusion: Surgical repair of acute MT-BFlh injuries enables return to preinjury level of sporting function with low risk of recurrence at short-term follow-up.
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