Description
VALIDATION OF THE PARISIAN HAMSTRING AVULSION SCORE (PHAS) IN THE EVALUATION AND FOLLOW-UP OF PATIENTS OPERATED FOR PROXIMAL HAMSTRING AVULSION.
S. KASSAB HASSAN 1,2, N. LEFEVRE1, E. VALENTIN 1, Y. BOHU 1, A. GEROMETTA 1, A. MEYER 1, O. GRIMAUD 1, A. HARDY 1
1 Clinique du Sport Paris V, Paris, France, 2 CHU Pitié-Salpêtrière, Paris, France
Topic: Muscle and Tendon
Objectives: Validation of a new assessment tool for patients following PHA surgery: the Parisian Hamstring Avulsion Score (PHAS).
Methods: All patients operated for a PHA between January 2015 and March 2018 were included in this study. A suspected clinical diagnosis of PHA was confirmed by MRI. PHA was repaired by surgical reinsertion with suture anchors. Minimum postoperative follow-up was 2 years and the Parisian Hamstring Avulsion Score (PHAS), UCLA and Tegner scores were used. The PHAS is a patient reported outcome measure, evaluating the impact of PHA injury with 9 items. It was validated by calculating its psychometric properties then correlation analysis was performed to determine the relationship between the PHAS, UCLA and Tegner scores. Cut-off values for the prediction of RTS were also determined.
Results: A prospective case series study was performed. A total of 156 patients were included. Median age was 54.2 (44.7; 61.3) years old and average final follow-up was at 69 (± 11.6) months. Two years after surgery 66.7% (n=104) of patients had RTS. There was strong correlation between all three scores at 1 year post-operatively.
Overall internal consistency was high, with a Cronbach’s alpha coefficient of 0.86. The intra-class correlation coefficient was 0.96 showing excellent reliability. Minimal detectable change value was 12.9. No patients reached the maximum score at 2 years. Analysis of the ROC curves of the 3 scores at post-operative 9 months in relation to the RTS at 1 and 2 years, showed AUC values of > 0.7, indicating significant discriminant capacity for the RTS. A PHAS score cut-off value of 86 at 9 months for the prediction of RTS at postoperative 1 year had a sensitivity of 65.6% [53.7 - 77.5] and a specificity of 81.4% [69.8 - 93].
Conclusions: PHAS score is a valid and reliable tool for follow-up after PHA surgery. It also offers a simple way to predict RTS.
