Nationwide Database Analysis Shows Proximal Hamstring Repair in Adult Patients Is Associated With Lower Failure and Complication Rates Than Reconstruction.

Abstract

To compare reoperation and complication rates after proximal hamstring repair and reconstruction in a large nationwide sample. This retrospective cross-sectional study used a large nationwide insurance claims database with deidentified data (PearlDiver). Adult patients undergoing proximal hamstring repair (Current Procedural Terminology code 27385) or reconstruction (Current Procedural Terminology code 27386) with a diagnosis of proximal hamstring tear (International Classification of Diseases, Tenth Revision code S7631X) were included. A minimum 2-year follow-up was required. Rates of reoperation, emergency department (ED) utilization, and major complications (venous thromboembolism [VTE], sciatic nerve injury, and deep postoperative infection) were tabulated. Complication rates and ED utilization were compared using the Fisher exact test, and reoperations were assessed using Kaplan-Meier analysis. A total of 2,813 patients (54.2% female) were included, with 2,656 undergoing proximal hamstring repair and 157 undergoing proximal hamstring reconstruction from 2015 to 2022. Proximal hamstring repair patients showed a lower 2-year reoperation rate compared with reconstruction patients (2.8% vs 5.7%, P = .038). The overall rates of VTE, sciatic nerve injury, and infection were 2.73%, 0.76%, and 0.91%, respectively. Patients undergoing repair showed lower rates of infection (0.69% vs 4.55%, P < .001) but had similar rates of sciatic nerve injury (0.81% vs 0.0%, P = .263) and VTE (2.62% vs 4.55%, P = .156) compared with patients undergoing reconstruction. There were no significant differences in rates of postoperative hospitalization or ED utilization. Patients undergoing proximal hamstring repair showed lower reoperation and postoperative infection rates compared with patients undergoing proximal hamstring reconstruction. Level III, retrospective comparative case series.