Thursday, November 25, 2010

Proximal Hamstring Avulsion Case Report

Quick review of the following article:
Surgical and Therapeutic Management of a Complete Proximal Hamstring Avulsion After Failed Conservative Approach

What information do you take away from reading a single article other than the main findings?

I like to see which outcome measures were used since there seems to be so much variability throughout the medical field. In this study they used the LEFS which seems to be a very popular scale. They also use the SportCord test which I actually had not heard of before this article (google was not much help to find more information about it, but they do describe the test in the article).

The patient had a Hamstring Repair using an Achilles Tendon Allograft. The article describes a new protocol that is criterion based and considers the basic tissue-healing process. They also add early loading to prevent secondary atrophy. The patient ended up having 25 sessions over 7 months to reach all goals. Despite her great outcomes she chose not to return to softball. The authors emphasized proximal control and lumbopelvic stabilization exercises which was lacking in the literature previously. They mention neuromusuclar control often which is a fairly subjective concept but a critical one that is beginning to be emphasized more often in the literature more recently.

Despite the "low level evidence" this provides it is a very useful article to have in the utility belt as a clinician.

2 comments:

t-denninger said...

Bo,

The sport cord test is utilized down here at Proaxis and also in Vail, CO at Howard Head Sports Medicine. There will be a reliability study in the coming months. For video explanation search search JOSPT for Beecher for another case study that come out of Proaxis.

Tom

BoDPT said...

Thanks Tom. They do describe it in the article and mention that it was originated over in Vail. I look forward to the reliability study.