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Surgical Technique: Open Proximal Hamstring Repair

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

The proximal hamstring is a common location for athletic injuries. A complete, three-tendon (semitendinosus, semimembranosus, long head biceps femoris) tear may occur in sports that involve eccentric contractions of the hamstrings with a rapid hip flexion and knee extension. Surgical treatment of multi-tendon tears with retraction in young active patients has demonstrated significantly better subjective and objective outcomes at short- and mid-term follow-up. A safe surgical approach is via the prone positioning, transverse or longitudinal skin incision, avoidance of the posterior femoral cutaneous nerve, exposure of the ischial tuberosity and proximal hamstring anatomic footprint, avoidance of the sciatic nerve (lateral to tuberosity), secure fixation via two or three double-loaded suture anchors, and meticulous hemostasis and closure. Chronic repair often requires extensive adhesiolysis, sciatic neurolysis, tendon mobilization, and possible allograft augmentation. Postoperative rehabilitation should avoid undue stress on the repair via avoiding hip flexion and knee extension.

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Author information

Authors and Affiliations

  1. Houston Methodist Center for Orthopaedics & Sports Medicine, 6550 Fannin Street, Smith Tower, Suite 2500, Houston, TX, 77030, USA

    Joshua D. Harris

  2. Rush University Medical Center, 1611 W. Harrison Street, Suite 300, Chicago, IL, 60612, USA

    Joshua D. Harris

  3. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  4. Midwest Orthopaedics at Rush, Hip Preservation Center, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  5. Rush University Medical Center, Chicago, IL, USA

    Charles A. Bush-Joseph

Authors
  1. Joshua D. Harris
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  2. Shane J. Nho
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  3. Charles A. Bush-Joseph
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Corresponding author

Correspondence to Joshua D. Harris .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

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© 2015 Springer Science+Business Media New York

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Harris, J.D., Nho, S.J., Bush-Joseph, C.A. (2015). Surgical Technique: Open Proximal Hamstring Repair. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_78

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  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_78

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6964-3

  • Online ISBN: 978-1-4614-6965-0

  • eBook Packages: MedicineReference Module Medicine

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