Proximal Hamstring Repair

Procedures

Overview

Proximal hamstring injuries occur when the hamstring tendon tears away from its attachment at the ischial tuberosity (sit bone) in the pelvis. These injuries can result in significant pain, weakness, and difficulty with activities such as running, climbing stairs, and prolonged sitting. Surgical repair is recommended for complete or high-grade partial tears that fail conservative treatment.

Types and Indications

Primary Repair:

  • Indicated for acute, complete retracted avulsions of the hamstring tendons from the ischial tuberosity, usually occurring after a forceful stretch or eccentric contraction.

  • Best performed within the first few weeks after injury for optimal healing.

Chronic Reconstruction:

  • Indicated for neglected or retracted hamstring tears where primary repair is not possible.

  • May involve tendon grafting or augmentation with allograft tissue.

The Procedure

The surgery is performed through an incision in the buttock crease. The surgeon identifies the torn hamstring tendons, clears scar tissue, and reattaches them to the ischial tuberosity using suture anchors. For chronic cases, additional soft tissue procedures may be needed to restore proper tension and function.

Recovery Process

  • Initial Phase (0-6 Weeks): Patients are typically placed in a brace limiting hip flexion and advised to use crutches to protect the repair.

  • Intermediate Phase (6-12 Weeks): Gradual strengthening and range of motion exercises begin.

  • Advanced Phase (3-6 Months): Progressive return to activity, including sport-specific training.

  • Full recovery may take 6-9 months, depending on the severity of the injury and rehabilitation progress.

Risks and Considerations

  • Potential complications include tendon re-tear, sciatic nerve irritation, persistent weakness, and stiffness.

  • Adherence to post-operative rehabilitation is crucial for optimal recovery.

Conclusion

Proximal hamstring repair is an effective treatment for patients with complete or high-grade hamstring tendon injuries that do not heal with conservative management. If you are experiencing persistent pain, weakness, or difficulty with activities, contact our office for a comprehensive evaluation and personalized treatment plan.