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Br J Sports Med. 2017 Sep;51(18):1355-1363. doi: 10.1136/bjsports-2016-096790. Epub 2017 Mar 4.

The prognostic value of MRI in determining reinjury risk following acute hamstring injury: a systematic review.

Author information

1
Department of Sports Medicine, VieCuri Medisch Centrum, Venlo, Limburg, The Netherlands.
2
Amsterdam Center of Evidence Based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands.
3
Department of Sports Medicine, The Sports Physician Group, OLVG, Amsterdam, The Netherlands.
4
Department of Sports Medicine, Aspetar Orthopaedics and Sports Medicine Hospital, Doha, Qatar.
5
Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
6
Department of Sports Medicine, Bergman Clinics, Naarden, The Netherlands.
7
The Sports Physician Group, Onze Lieve Vrouwe Gasthuis West, Amsterdam, The Netherlands.
8
Sports Groin Pain Centre, Aspetar Orthopaedics and Sports Medicine Hospital, Doha, Qatar.
9
School of Public Health, University of Sydney, Sydney, Australia.
10
The Sports Physician Group, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

A challenge for sports physicians is to estimate the risk of a hamstring re-injury, but the current evidence for MRI variables as a risk factor is unknown.

OBJECTIVE:

To systematically review the literature on the prognostic value of MRI findings at index injury and/or return to play for acute hamstring re-injuries.

DATA SOURCES:

Databases of PubMed, Embase, MEDLINE, Scopus, CINAHL, Google Scholar, Web of Science, LILACS, SciELO, ScienceDirect, ProQuest, SPORTDiscus and Cochrane Library were searched until 20 June 2016.

STUDY ELIGIBILITY CRITERIA:

Studies evaluating MRI as a prognostic tool for determining the risk of re-injury for athletes with acute hamstring injuries were eligible for inclusion.

DATA ANALYSIS:

Two authors independently screened the search results and assessed risk of bias using standardised criteria from a consensus statement. A best-evidence synthesis was used to identify the level of evidence. Post hoc analysis included correction for insufficient sample size.

RESULTS:

Of the 11 studies included, 7 had a low and 4 had a high risk of bias. No strong evidence for any MRI finding as a risk factor for hamstring re-injury was found. There was moderate evidence that intratendinous injuries were associated with increased re-injury risk. Post hoc analysis showed moderate evidence that injury to the biceps femoris was a moderate to strong risk factor for re-injury.

CONCLUSION:

There is currently no strong evidence for any MRI finding in predicting hamstring re-injury risk. Intratendinous injuries and biceps femoris injuries showed moderate evidence for association with a higher re-injury risk.

SYSTEMATIC REVIEW REGISTRATION:

Registration in the PROSPERO International prospective register of systematic reviews was performed prior to study initiation (registration number CRD42015024620).

KEYWORDS:

Hamstring; MRI; Recurrent; Risk factor; Thigh

PMID:
28259847
DOI:
10.1136/bjsports-2016-096790
[Indexed for MEDLINE]

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