Oslo Sports Trauma Research Center

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Information about project titled 'Hamstring Reinjuries Occur at the Same Location and Early After Return to Sport - A Descriptive Study of MRI-Confirmed Reinjuries'

Hamstring Reinjuries Occur at the Same Location and Early After Return to Sport - A Descriptive Study of MRI-Confirmed Reinjuries

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Project status: Published
Project manager: Arnlaug Wangensteen
Supervisor(s): Johannes Tol, Roald Bahr
Coworker(s): Erik Witvrouw, Robbart van Linschoten, Emad Almusa, Bruce Hamilton

Description

Background: Despite relatively high reinjury rates after acute hamstring injuries, there is a lack of detailed knowledge about where and when hamstring reinjuries occur, and studies including imaging-confirmed reinjuries are scarce.

Aims: To investigate the location, radiological severity, and timing of reinjuries on magnetic resonance imaging (MRI) compared with the index injury.

Study Design: Case series

Methods: A MRI scan was obtained _5 days after an acute hamstring index injury in 180 athletes, and time to return to sport (RTS) was registered. Athletes with an MRI-confirmed reinjury in the same leg _365 days after RTS were included. Categorical grading and standardized MRI parameters of the index injury and reinjury were scored by a single radiologist (with excellent intraobserver reliability). To determine the location of the reinjury, axial and coronal views of the index injury and reinjury were directly compared on proton density–weighted fat-suppressed images.

Results: In the 19 athletes included with reinjury, 79% of these reinjuries occurred in the same location within the muscle as the index injury. The median time to RTS after the index injury was 19 days (range, 5-37 days; interquartile range [IQR], 15 days). The median time between the index injury and reinjury was 60 days (range, 20-316 days; IQR, 131 days) and the median time between RTS after the index injury and the reinjury was 24 days (range, 4-311 days; IQR, 140 days). More than 50% of reinjuries occurred within 25 days (4 weeks) after RTS from the index injury and 50% occurred within 50 days after the index injury. All reinjuries with more severe radiological grading occurred in the same location as the index injury.

Conclusion: The majority of the hamstring reinjuries occurred in the same location as the index injury, early after RTS and with a radiologically greater extent, suggesting incomplete biological and/or functional healing of the index injury.