Kathryn B Metcalf1,2,3, Derrick M Knapik1,2, James E Voos1,2. 1. 1Sports Medicine Institute, University Hospital, Cleveland, OH USA. 2. 2School of Medicine, Case Western Reserve University, Cleveland, OH USA. 3. Department of Orthopaedic Surgery, 11100 Euclid Avenue, Cleveland, OH 44106 USA.
Abstract
BACKGROUND: Isolated distal semitendinosus tears and avulsions sustained during sporting activities are uncommon. QUESTION/PURPOSES: We sought to systematically review the literature to identify athletes sustaining distal semitendinosus tears and avulsions during sporting activities and to better understand injury mechanisms, management, and return-to-sport timing. METHODS: PubMed, Biosis Previews, SPORTDiscus, PEDro, and EMBASE databases were searched from January 1970 to January 2018 using the search terms distal hamstring, semitendinosus, sport, athlete, tear, rupture, and avulsion. Inclusion criteria were studies documenting (1) isolated, complete distal semitendinosus tears and avulsions during sporting activity, (2) injury management, and (3) athlete outcome. Exclusion criteria were studies reporting (1) partial tears, (2) injuries from non-sporting activities, or (3) athlete sustaining injury with concomitant injuries about the knee. Sporting activities, tear location, management strategy, time from injury to surgery, and return-to-sport timing were analyzed. Statistical analysis was used to evaluate return-to-sport timing based on treatment type and tear location. RESULTS: Four studies met the inclusion criteria, comprising a total of 23 cases of complete, isolated distal semitendinosus avulsions or tears. Injuries were sustained predominantly while running or sprinting and most commonly were avulsions off the tibia. Injuries were treated surgically in 70% of cases. Overall time to return to sport was 2.5 ± 1.4 months with athletes treated conservatively returning significantly more quickly (1.5 ± 0.8 months) than athletes undergoing surgery (3.0 ± 1.3 months). Return-to-sport time was significantly shorter in athletes with complete avulsions (2.2 ± 1.3 months) than in those sustaining tears at the musculotendinous junction (3.8 ± 0.8 months). No significant correlation between time to surgery and return-to-sport time was appreciated. CONCLUSION: Isolated, complete distal semitendinosus tears and avulsions remain infrequently reported during sporting activities and, in this review, occurred predominantly during non-contact activity. Athletes treated conservatively were found to return to sport more quickly, although additional studies are needed to determine the clinical relevance of treatment option, tear location, and concurrent injuries.
BACKGROUND: Isolated distal semitendinosus tears and avulsions sustained during sporting activities are uncommon. QUESTION/PURPOSES: We sought to systematically review the literature to identify athletes sustaining distal semitendinosus tears and avulsions during sporting activities and to better understand injury mechanisms, management, and return-to-sport timing. METHODS: PubMed, Biosis Previews, SPORTDiscus, PEDro, and EMBASE databases were searched from January 1970 to January 2018 using the search terms distal hamstring, semitendinosus, sport, athlete, tear, rupture, and avulsion. Inclusion criteria were studies documenting (1) isolated, complete distal semitendinosus tears and avulsions during sporting activity, (2) injury management, and (3) athlete outcome. Exclusion criteria were studies reporting (1) partial tears, (2) injuries from non-sporting activities, or (3) athlete sustaining injury with concomitant injuries about the knee. Sporting activities, tear location, management strategy, time from injury to surgery, and return-to-sport timing were analyzed. Statistical analysis was used to evaluate return-to-sport timing based on treatment type and tear location. RESULTS: Four studies met the inclusion criteria, comprising a total of 23 cases of complete, isolated distal semitendinosus avulsions or tears. Injuries were sustained predominantly while running or sprinting and most commonly were avulsions off the tibia. Injuries were treated surgically in 70% of cases. Overall time to return to sport was 2.5 ± 1.4 months with athletes treated conservatively returning significantly more quickly (1.5 ± 0.8 months) than athletes undergoing surgery (3.0 ± 1.3 months). Return-to-sport time was significantly shorter in athletes with complete avulsions (2.2 ± 1.3 months) than in those sustaining tears at the musculotendinous junction (3.8 ± 0.8 months). No significant correlation between time to surgery and return-to-sport time was appreciated. CONCLUSION: Isolated, complete distal semitendinosus tears and avulsions remain infrequently reported during sporting activities and, in this review, occurred predominantly during non-contact activity. Athletes treated conservatively were found to return to sport more quickly, although additional studies are needed to determine the clinical relevance of treatment option, tear location, and concurrent injuries.
Authors: Ernest Schilders; Quamar Bismil; Sameh Sidhom; Philip Robinson; Tom Barwick; Charlie Talbot Journal: Knee Date: 2005-08-25 Impact factor: 2.199
Authors: José Afonso; Sílvia Rocha-Rodrigues; Filipe M Clemente; Michele Aquino; Pantelis T Nikolaidis; Hugo Sarmento; Alberto Fílter; Jesús Olivares-Jabalera; Rodrigo Ramirez-Campillo Journal: Front Physiol Date: 2021-07-07 Impact factor: 4.566