Early Versus Delayed Repair of Proximal Hamstring Tendon Ruptures: A Systematic Review and Meta-analysis.
Muzammil Akhtar, Marlena Ramanis, Kory Pasko et al.
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In 30 seconds
This systematic review and meta-analysis compared early with delayed primary repair of proximal hamstring tendon ruptures in adults. Early repair was defined as surgery within 4 to 6 weeks of injury. Across 12 studies, including 992 early and 728 delayed repairs, patient-reported outcomes were mostly similar, although 3 of 9 studies reporting these outcomes found at least one significantly higher score with early repair. Early repair was associated with lower risks of postoperative sciatica (RR, 0.26; P = .009) and retear (RR, 0.51; P = .03).
Key findings
- Early repair was associated with reduced postoperative sciatica risk (RR, 0.26; P = .009).
- Early repair was associated with reduced retear risk (RR, 0.51; P = .03).
- Peri-incisional numbness, infection, and revision risks did not differ significantly between timing groups.
- Patient-reported outcomes were mostly similar; 3 of 9 studies found at least one significantly higher score with early repair.
Why it matters
Timing may be relevant to postoperative complications after proximal hamstring tendon repair. The pooled findings suggest lower risks of sciatica and retear with repair within 4 to 6 weeks, while patient-reported outcomes and several other complications were generally similar. This helps frame the potential benefits of earlier repair without implying that all outcomes consistently favor early surgery.
What to keep in mind
The review included studies with heterogeneous return-to-sport measures and variable patient-reported outcome findings; the abstract does not specify that the underlying studies were randomised.