Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2017

01-06-2017 | Hip

Proximal hamstring tendon avulsion surgery: evaluation of the Perth Hamstring Assessment Tool

Authors: William G. Blakeney, Simon R. Zilko, Steven J. Edmonston, Natalie E. Schupp, Peter T. Annear

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2017

Login to get access

Abstract

Purpose

The purpose of the present study was to validate a new scoring system for proximal hamstring injury—the Perth Hamstring Assessment Tool (PHAT).

Methods

This is a prospective series of 74 consecutive proximal hamstring surgical repairs in 72 patients, with a median age of 50.5 years (range 16–74). Patients completed the PHAT, SF12 Health Survey and Lower Extremity Functional Scale (LEFS). The scoring system was validated by calculating its internal consistency, reproducibility, reliability and sensitivity to change. Construct validity was evaluated using Pearson’s correlation analysis to examine the strength of association between the PHAT, LEFS and SF-12 scores.

Results

The PHAT showed high completion rate (100 %), high internal consistency (Cronbach’s alpha 0.80), high reproducibility (ICC 0.84) and high sensitivity to change. There was moderate correlation with the LEFS and low correlation with the Physical Component Score of the SF-12.

Conclusion

This study has validated the PHAT as an assessment tool for proximal hamstring tendon injuries. The new questionnaire provides a measure of outcome that is reliable and sensitive to clinically important change. This simple questionnaire provides the clinician with a quick and practical tool for assessing patients with proximal hamstring injuries: to assess pre-operative disability and monitor recovery post-operatively.

Level of evidence

II.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bencardino JT, Mellado JM (2005) Hamstring injuries of the hip. Magn Reson Imaging Clin N Am 13:677–690CrossRefPubMed Bencardino JT, Mellado JM (2005) Hamstring injuries of the hip. Magn Reson Imaging Clin N Am 13:677–690CrossRefPubMed
2.
go back to reference Binkley JM, Stratford PW, Lott SA, Riddle DL (1999) The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther 79:371–383PubMed Binkley JM, Stratford PW, Lott SA, Riddle DL (1999) The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther 79:371–383PubMed
3.
go back to reference Birmingham P, Muller M, Wickiewicz T, Cavanaugh J, Rodeo S, Warren R (2011) Functional outcome after repair of proximal hamstring avulsions. J Bone Joint Surg Am 93:1819–1826CrossRefPubMed Birmingham P, Muller M, Wickiewicz T, Cavanaugh J, Rodeo S, Warren R (2011) Functional outcome after repair of proximal hamstring avulsions. J Bone Joint Surg Am 93:1819–1826CrossRefPubMed
4.
go back to reference Blasier RB, Morawa LG (1990) Complete rupture of the hamstring origin from a water skiing injury. Am J Sports Med 18:435–437CrossRefPubMed Blasier RB, Morawa LG (1990) Complete rupture of the hamstring origin from a water skiing injury. Am J Sports Med 18:435–437CrossRefPubMed
5.
go back to reference Bowman KF, Cohen SB, Bradley JP (2013) Operative management of partial-thickness tears of the proximal hamstring muscles in athletes. Am J Sports Med 41:1363–1371CrossRefPubMed Bowman KF, Cohen SB, Bradley JP (2013) Operative management of partial-thickness tears of the proximal hamstring muscles in athletes. Am J Sports Med 41:1363–1371CrossRefPubMed
6.
go back to reference Brucker PU, Imhoff AB (2005) Functional assessment after acute and chronic complete ruptures of the proximal hamstring tendons. Knee Surg Sports Traumatol Arthrosc 13:411–418CrossRefPubMed Brucker PU, Imhoff AB (2005) Functional assessment after acute and chronic complete ruptures of the proximal hamstring tendons. Knee Surg Sports Traumatol Arthrosc 13:411–418CrossRefPubMed
7.
go back to reference Chakravarthy J, Ramisetty N, Pimpalnerkar A, Mohtadi N (2005) Surgical repair of complete proximal hamstring tendon ruptures in water skiers and bull riders: a report of four cases and review of the literature. Br J Sports Med 39:569–572CrossRefPubMedPubMedCentral Chakravarthy J, Ramisetty N, Pimpalnerkar A, Mohtadi N (2005) Surgical repair of complete proximal hamstring tendon ruptures in water skiers and bull riders: a report of four cases and review of the literature. Br J Sports Med 39:569–572CrossRefPubMedPubMedCentral
8.
go back to reference Cohen SB, Rangavajjula A, Vyas D, Bradley JP (2012) Functional results and outcomes after repair of proximal hamstring avulsions. Am J Sports Med 40:2092–2098CrossRefPubMed Cohen SB, Rangavajjula A, Vyas D, Bradley JP (2012) Functional results and outcomes after repair of proximal hamstring avulsions. Am J Sports Med 40:2092–2098CrossRefPubMed
9.
go back to reference Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69CrossRefPubMed Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69CrossRefPubMed
10.
go back to reference Fitzpatrick R, Ziebland S, Jenkinson C, Mowat A, Mowat A (1992) Importance of sensitivity to change as a criterion for selecting health status measures. Qual Health Care 1:89–93CrossRefPubMedPubMedCentral Fitzpatrick R, Ziebland S, Jenkinson C, Mowat A, Mowat A (1992) Importance of sensitivity to change as a criterion for selecting health status measures. Qual Health Care 1:89–93CrossRefPubMedPubMedCentral
11.
go back to reference Floor S, van der Veen AH, Devilee RJ (2010) Two patients with a complete proximal rupture of the hamstring. Arch Orthop Trauma Surg 130:523–526CrossRefPubMed Floor S, van der Veen AH, Devilee RJ (2010) Two patients with a complete proximal rupture of the hamstring. Arch Orthop Trauma Surg 130:523–526CrossRefPubMed
12.
go back to reference Folsom GJ, Larson CM (2008) Surgical treatment of acute versus chronic complete proximal hamstring ruptures: results of a new allograft technique for chronic reconstructions. Am J Sports Med 36:104–109CrossRefPubMed Folsom GJ, Larson CM (2008) Surgical treatment of acute versus chronic complete proximal hamstring ruptures: results of a new allograft technique for chronic reconstructions. Am J Sports Med 36:104–109CrossRefPubMed
13.
go back to reference Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) Cross-validation of item selection and scoring for the SF-12 health survey in nine countries. J Clin Epidemiol 51:1171–1178CrossRefPubMed Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) Cross-validation of item selection and scoring for the SF-12 health survey in nine countries. J Clin Epidemiol 51:1171–1178CrossRefPubMed
14.
go back to reference Gidwani S, Bircher MD (2007) Avulsion injuries of the hamstring origin—a series of 12 patients and management algorithm. Ann R Coll Surg Engl 89:394–399CrossRefPubMedPubMedCentral Gidwani S, Bircher MD (2007) Avulsion injuries of the hamstring origin—a series of 12 patients and management algorithm. Ann R Coll Surg Engl 89:394–399CrossRefPubMedPubMedCentral
15.
go back to reference Harris JD, Griesser MJ, Best TM, Ellis TJ (2011) Treatment of proximal hamstring ruptures—a systematic review. Int J Sports Med 32:490–495CrossRefPubMed Harris JD, Griesser MJ, Best TM, Ellis TJ (2011) Treatment of proximal hamstring ruptures—a systematic review. Int J Sports Med 32:490–495CrossRefPubMed
16.
go back to reference Hinkle DE, Wiersma W, Jurs SG (2003) Applied statistics for the behavioral sciences. Houghton Mifflin, Boston, pp 107–110 Hinkle DE, Wiersma W, Jurs SG (2003) Applied statistics for the behavioral sciences. Houghton Mifflin, Boston, pp 107–110
17.
go back to reference Ishikawa K, Kai K, Mizuta H (1988) Avulsion of the hamstring muscles from the ischial tuberosity. A report of two cases. Clin Orthop Relat Res 232:153–155 Ishikawa K, Kai K, Mizuta H (1988) Avulsion of the hamstring muscles from the ischial tuberosity. A report of two cases. Clin Orthop Relat Res 232:153–155
18.
go back to reference Jette DU, Jette AM (1996) Physical therapy and health outcomes in patients with knee impairments. Phys Ther 76:1178–1187CrossRefPubMed Jette DU, Jette AM (1996) Physical therapy and health outcomes in patients with knee impairments. Phys Ther 76:1178–1187CrossRefPubMed
19.
go back to reference Klingele KE, Sallay PI (2002) Surgical repair of complete proximal hamstring tendon rupture. Am J Sports Med 30:742–747PubMed Klingele KE, Sallay PI (2002) Surgical repair of complete proximal hamstring tendon rupture. Am J Sports Med 30:742–747PubMed
20.
go back to reference Konan S, Haddad F (2010) Successful return to high level sports following early surgical repair of complete tears of the proximal hamstring tendons. Int Orthop 34:119–123CrossRefPubMed Konan S, Haddad F (2010) Successful return to high level sports following early surgical repair of complete tears of the proximal hamstring tendons. Int Orthop 34:119–123CrossRefPubMed
21.
go back to reference Kurosawa H, Nakasita K, Nakasita H, Sasaki S, Takeda S (1996) Complete avulsion of the hamstring tendons from the ischial tuberosity. A report of two cases sustained in judo. Br J Sports Med 30:72–74CrossRefPubMedPubMedCentral Kurosawa H, Nakasita K, Nakasita H, Sasaki S, Takeda S (1996) Complete avulsion of the hamstring tendons from the ischial tuberosity. A report of two cases sustained in judo. Br J Sports Med 30:72–74CrossRefPubMedPubMedCentral
22.
go back to reference Lempainen L, Sarimo J, Heikkilä J, Mattila K, Orava S (2006) Surgical treatment of partial tears of the proximal origin of the hamstring muscles. Br J Sports Med 40:688–691CrossRefPubMedPubMedCentral Lempainen L, Sarimo J, Heikkilä J, Mattila K, Orava S (2006) Surgical treatment of partial tears of the proximal origin of the hamstring muscles. Br J Sports Med 40:688–691CrossRefPubMedPubMedCentral
23.
go back to reference van der Made AD, Reurink G, Gouttebarge V, Tol JL, Kerkhoffs GM (2015) Outcome after surgical repair of proximal hamstring avulsions: a systematic review. Am J Sports Med 43:2841–2851CrossRefPubMed van der Made AD, Reurink G, Gouttebarge V, Tol JL, Kerkhoffs GM (2015) Outcome after surgical repair of proximal hamstring avulsions: a systematic review. Am J Sports Med 43:2841–2851CrossRefPubMed
24.
go back to reference Mansour AA, Genuario JW, Young JP, Murphy TP, Boublik M, Schlegel TF (2013) National football league athletes’ return to play after surgical reattachment of complete proximal hamstring ruptures. Am J Orthop 42:E38–E41PubMed Mansour AA, Genuario JW, Young JP, Murphy TP, Boublik M, Schlegel TF (2013) National football league athletes’ return to play after surgical reattachment of complete proximal hamstring ruptures. Am J Orthop 42:E38–E41PubMed
25.
go back to reference Marx RG, Fives G, Chu SK, Daluiski A, Wolfe SW (2009) Allograft reconstruction for symptomatic chronic complete proximal hamstring tendon avulsion. Knee Surg Sports Traumatol Arthrosc 17:19–23CrossRefPubMed Marx RG, Fives G, Chu SK, Daluiski A, Wolfe SW (2009) Allograft reconstruction for symptomatic chronic complete proximal hamstring tendon avulsion. Knee Surg Sports Traumatol Arthrosc 17:19–23CrossRefPubMed
26.
go back to reference Mica L, Schwaller A, Stoupis C, Penka I, Vomela J, Vollenweider A (2009) Avulsion of the hamstring muscle group: a follow-up of 6 adult non-athletes with early operative treatment: a brief report. World J Surg 33:1605–1610CrossRefPubMed Mica L, Schwaller A, Stoupis C, Penka I, Vomela J, Vollenweider A (2009) Avulsion of the hamstring muscle group: a follow-up of 6 adult non-athletes with early operative treatment: a brief report. World J Surg 33:1605–1610CrossRefPubMed
27.
go back to reference Murray PJ, Lowe WR (2009) Achilles allograft reconstruction of a chronic complete proximal hamstring rupture. Knee Surg Sports Traumatol Arthrosc 17:1360–1363CrossRefPubMed Murray PJ, Lowe WR (2009) Achilles allograft reconstruction of a chronic complete proximal hamstring rupture. Knee Surg Sports Traumatol Arthrosc 17:1360–1363CrossRefPubMed
28.
go back to reference Orava S, Kujala UM (1995) Rupture of the ischial origin of the hamstring muscles. Am J Sports Med 23:702–705CrossRefPubMed Orava S, Kujala UM (1995) Rupture of the ischial origin of the hamstring muscles. Am J Sports Med 23:702–705CrossRefPubMed
29.
go back to reference Sallay PI, Ballard G, Hamersly S, Schrader M (2008) Subjective and functional outcomes following surgical repair of complete ruptures of the proximal hamstring complex. Orthopedics 31:1092CrossRefPubMed Sallay PI, Ballard G, Hamersly S, Schrader M (2008) Subjective and functional outcomes following surgical repair of complete ruptures of the proximal hamstring complex. Orthopedics 31:1092CrossRefPubMed
30.
go back to reference Sallay PI, Friedman RL, Coogan PG, Garrett WE (1996) Hamstring muscle injuries among water skiers. Functional outcome and prevention. Am J Sports Med 24:130–136CrossRefPubMed Sallay PI, Friedman RL, Coogan PG, Garrett WE (1996) Hamstring muscle injuries among water skiers. Functional outcome and prevention. Am J Sports Med 24:130–136CrossRefPubMed
31.
go back to reference Sarimo J, Lempainen L, Mattila K, Orava S (2008) Complete proximal hamstring avulsions: a series of 41 patients with operative treatment. Am J Sports Med 36:1110–1115CrossRefPubMed Sarimo J, Lempainen L, Mattila K, Orava S (2008) Complete proximal hamstring avulsions: a series of 41 patients with operative treatment. Am J Sports Med 36:1110–1115CrossRefPubMed
32.
go back to reference Skaara HE, Moksnes H, Frihagen F, Stuge B (2013) Self-reported and performance-based functional outcomes after surgical repair of proximal hamstring avulsions. Am J Sports Med 41:2577–2584CrossRefPubMed Skaara HE, Moksnes H, Frihagen F, Stuge B (2013) Self-reported and performance-based functional outcomes after surgical repair of proximal hamstring avulsions. Am J Sports Med 41:2577–2584CrossRefPubMed
33.
go back to reference Stevens MA, El-Khoury GY, Kathol MH, Brandser EA, Chow S (1999) Imaging features of avulsion injuries. Radiographics 19:655–672CrossRefPubMed Stevens MA, El-Khoury GY, Kathol MH, Brandser EA, Chow S (1999) Imaging features of avulsion injuries. Radiographics 19:655–672CrossRefPubMed
34.
go back to reference Ware J, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed Ware J, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed
35.
go back to reference Wood DG, Packham I, Trikha SP, Linklater J (2008) Avulsion of the proximal hamstring origin. J Bone Joint Surg Am 90:2365–2374CrossRefPubMed Wood DG, Packham I, Trikha SP, Linklater J (2008) Avulsion of the proximal hamstring origin. J Bone Joint Surg Am 90:2365–2374CrossRefPubMed
Metadata
Title
Proximal hamstring tendon avulsion surgery: evaluation of the Perth Hamstring Assessment Tool
Authors
William G. Blakeney
Simon R. Zilko
Steven J. Edmonston
Natalie E. Schupp
Peter T. Annear
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4214-y

Other articles of this Issue 6/2017

Knee Surgery, Sports Traumatology, Arthroscopy 6/2017 Go to the issue