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Total proximal hamstring ruptures: clinical and MRI aspects including guidelines for postoperative rehabilitation

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The aim of this article is to provide a state-of-the-art review for treatment of acute, total proximal hamstring tendon ruptures. For total proximal hamstring tendon ruptures, early (<2–3 w) surgical refixation minimizes muscle atrophy and facilitates a somewhat predictable time course for healing and rehabilitation. A postoperative rehabilitation program is detailed that has been used by one physical therapist for the past 7 years on over 200 patients with surgical repair for total proximal hamstring tendon rupture. One re-rupture has occurred, 7 months after surgery, following the rehabilitation program described herein. The rehabilitation program, including avoidance of postoperative bracing, appears effective for total proximal hamstring ruptures. Early surgery together with a specific rehabilitation program appears to be the treatment of choice for timely and safe return to sport and an active lifestyle.

Level of evidence V.

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Acknowledgments

The authors thank Dr Sven Jönhagen, Danderyd Sjukhus, Stockholm, and Dr Karl Eriksson, Södersjukhuset, Stockholm, for their skilful cooperation and assistance.

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Authors and Affiliations

  1. The Swedish School of Sport and Health Sciences, Stockholm, Sweden

    Carl M. Askling

  2. Section of Orthopaedics and Sports Medicine, Department of Molecular Medicine and Surgery, KarolinskaInstitutet, Stockholm, Sweden

    Carl M. Askling

  3. Melbourne Radiology Clinic, East Melbourne, Australia

    George Koulouris

  4. Centre for Orthopaedic Research, School of Surgery, University of Western Australia, Nedlands, Australia

    George Koulouris

  5. Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden

    Tönu Saartok & Suzanne Werner

  6. Department of Orthopaedics, Visby Hospital, Visby, Sweden

    Tönu Saartok

  7. Department of Family Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, OH, USA

    Thomas M. Best

  8. Department of Molecular Medicine and Surgery, Stockholm, Sweden

    Suzanne Werner

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  1. Carl M. Askling
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  2. George Koulouris
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  3. Tönu Saartok
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  4. Suzanne Werner
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  5. Thomas M. Best
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Corresponding author

Correspondence to Carl M. Askling.

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Askling, C.M., Koulouris, G., Saartok, T. et al. Total proximal hamstring ruptures: clinical and MRI aspects including guidelines for postoperative rehabilitation. Knee Surg Sports Traumatol Arthrosc 21, 515–533 (2013). https://doi.org/10.1007/s00167-012-2311-0

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  • DOI: https://doi.org/10.1007/s00167-012-2311-0

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