Complete resolution of a hamstring intramuscular tendon injury on MRI is not necessary for a clinically successful return to play

Robin Vermeulen*, Emad Almusa, Stan Buckens, Willem Six, Rod Whiteley, Guus Reurink, Adam Weir, Maarten Moen, Gino M.M.J. Kerkhoffs, Johannes L. Tol

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)

Abstract

Background Clinical decision-making around intramuscular tendon injuries of the hamstrings is a controversial topic in sports medicine. For this injury, MRI at return to play (RTP) might improve RTP decision-making; however, no studies have investigated this. Objective Our objectives were to describe MRI characteristics at RTP, to evaluate healing and to examine the association of MRI characteristics at RTP with reinjury for clinically recovered hamstring intramuscular tendon injuries. Methods We included 41 athletes with hamstring intramuscular tendon injuries and an MRI at baseline and RTP. For both MRIs, we used a standardised scoring form that included intramuscular tendon injury characteristics. We recorded reinjuries during 1-year follow-up. Results At RTP, 56% of the intramuscular tendons showed a partial or complete thickness tendon discontinuity. Regarding healing from injury to RTP, 18 of 34 (44% overall) partial-Thickness tendon discontinuities became continuous and 6 out of 7 (15% overall) complete thickness tendon discontinuities became partial-Thickness tendon discontinuities. Waviness decreased from 61% to 12%, and 88% of tendons became thickened. We recorded eight (20%) reinjuries within 1 year. Intramuscular tendon characteristics at RTP between participants with or without a reinjury were similar. Conclusion Complete resolution of an intramuscular tendon injury on MRI is not necessary for clinically successful RTP. From injury to RTP, the intramuscular tendon displayed signs of healing. Intramuscular tendon characteristics of those with or without a reinjury were similar.

Original languageEnglish
Pages (from-to)397-402
Number of pages6
JournalBritish Journal of Sports Medicine
Volume55
Issue number7
DOIs
Publication statusPublished - 1 Apr 2021

Bibliographical note

Funding: The Growth Factor study (Qatar) was internally funded by Aspetar. The Hamstring Injection Therapy (Dutch) study was supported by Arthrex Medizinische Instrumente GmbH and the Royal Dutch Football Association.

Publisher Copyright: © 2021 BMJ Publishing Group. All rights reserved.

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