Purpose: The purpose of this study is to compare reoperation rates and complications after proximal hamstring repair and reconstruction in a large nationwide sample.

Methods: This retrospective cross-sectional study utilized a large nationwide insurance claims database with de-identified data (PearlDiver, Colorado, USA). Adult patients undergoing proximal hamstring repair (CPT-27385) or reconstruction (CPT-27386) with a diagnosis of proximal hamstring tear (ICD-10-S7631X) were included. A minimum two-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 Fisher's exact tests and reoperations were assessed using Kaplan-Meier analysis.

Results: 2,813 patients (54.2% female) were included, with 2,656 undergoing proximal hamstring repair and 157 undergoing proximal hamstring reconstruction between 2010 and 2022. Proximal hamstring repair demonstrated a lower 2-year reoperation rate compared to reconstruction (2.8% vs. 5.7%, p=0.038). The overall rates for VTE, sciatic nerve injury, and infection were 2.73%, 0.76%, and 0.91%, respectively. Patients undergoing repair demonstrated lower rates of infection (0.69% vs 4.55%, p<0.001) but had similar rates of sciatic nerve injury (0.81% vs 0.0%, p=0.263) and VTE (2.62% vs 4.55%, p=0.156) compared to patients undergoing reconstruction. There were no significant differences in rates of postoperative hospitalization or ED utilization.

Conclusions: Patients undergoing proximal hamstring repair demonstrated lower reoperation and post-operative infection rates compared to patients undergoing proximal hamstring reconstruction.

Level of evidence: III Retrospective comparative case series.

Copyright © 2025. Published by Elsevier Inc.

目的： 本研究的目的是在一个大型全国样本中比较近端腘绳肌修复和重建后的再次手术率和并发症。

方法： 这项回顾性横断面研究使用了一个带有匿名数据的大规模全国保险索赔数据库（美国科罗拉多州PearlDiver）。纳入标准为成年患者进行近端腘绳肌修复（CPT-27385）或重建（CPT-27386），并被诊断为近端腘绳肌撕裂（ICD-10-S7631X）。要求至少两年的随访期。记录了再次手术率、急诊科（ED）使用情况以及重大并发症（静脉血栓栓塞症[VTE]、坐骨神经损伤和深部术后感染）的发生率。利用Fisher确切检验比较并发症发生率和急诊科使用情况，并用Kaplan-Meier分析评估再手术情况。

结果： 2010年至2022年间，共有2,813名患者（女性占54.2%）被纳入研究，其中2,656人进行了近端腘绳肌修复，157人进行了重建。与重建相比，近端腘绳肌修复的两年再手术率较低（2.8% vs 5.7%，p=0.038）。总体而言，VTE、坐骨神经损伤和感染的发生率为2.73%、0.76% 和 0.91%。进行修复治疗的患者表现出较低的感染发生率（0.69% 对比 4.55%，p

结论： 接受近端腘绳肌修复的患者与接受重建治疗的患者相比，表现出较低的再手术和术后感染发生率。

证据水平： III级 回顾性比较病例系列研究。