Literature DB >> 28903949

Intramuscular tendon involvement on MRI has limited value for predicting time to return to play following acute hamstring injury.

Anne D van der Made1,2,3,4, Emad Almusa1, Rod Whiteley1, Bruce Hamilton5, Cristiano Eirale1, Frank van Hellemondt1, Johannes L Tol1,3.   

Abstract

BACKGROUND: Hamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias.
OBJECTIVE: Determine whether intramuscular tendon involvement is associated with delayed RTP and elevated rates of reinjury.
METHODS: MRI of male athletes with an acute hamstring injury was obtained within 5 days of injury. Evaluation included standardised MRI scoring and scoring of intramuscular tendon involvement. Time to RTP and reinjury rate were prospectively recorded.
RESULTS: Out of 70 included participants, intramuscular tendon disruption was present in 29 (41.4%) injuries. Injuries without intramuscular tendon disruption had a mean time to RTP of 22.2±7.4 days. Injuries with <50%, 50%-99% and 100% disruption of tendon cross-sectional area had a mean time to RTP of 24.0±9.7, 25.3±8.6 and 31.6±10.9 days, respectively. Injuries with full-thickness disruption took longer to RTP compared with injuries without disruption (p=0.025). Longitudinal intramuscular tendon disruption was not significantly associated with time to RTP. Waviness was present in 17 (24.3%) injuries. Mean time to RTP for injuries without and with waviness was 22.6±7.5 and 30.2±10.8 days (p=0.014). There were 11 (15.7%) reinjuries within 12 months, five (17.2%) in the group with intramuscular tendon disruption and six (14.6%) in the group without intramuscular tendon disruption.
CONCLUSION: Time to RTP for injuries with full-thickness disruption of the intramuscular tendon and waviness is significantly longer (by slightly more than 1 week) compared with injuries without intramuscular tendon involvement. However, due to the considerable overlap in time to RTP between groups with and without intramuscular tendon involvement, its clinical significance for the individual athlete is limited. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Entities:  

Keywords:  hamstring; mri; muscle Injury; tendon

Mesh：

Year:  2017        PMID： 28903949     DOI： 10.1136/bjsports-2017-097659

Source DB:  PubMed          Journal:  Br J Sports Med        ISSN： 0306-3674            Impact factor:   13.800


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