Abstract
Proximal hamstring injuries are common in athletes. Surgical indications are based on to regain the pre-injury activity level of the athlete. The key to achieve athletes back to play is to understand that hamstrings consist of three different muscles that have different functions. The rupture of proximal hamstring tendon can occur to one, two or all of these three tendons (semitendinosus, semimembranosus and biceps femoris), which may result in disability and chronic pain and prevent athletes from participating in competitive sports. Surgery with open technique provides good visibility to hamstring tendons, nervous structures and bony insertion landmarks. This chapter gives the reader the indications for proximal hamstring tendon avulsion surgery together with the surgical technique and post-operative rehabilitation. We also discuss possible complications of the operative treatment.
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References
Harris JD, Griesser MJ, Best TM, Ellis TJ. Treatment of proximal hamstring ruptures - a systematic review. Int J Sports Med. 2011;32:490–5.
Lempainen L, Banke IJ, Johansson K, Brucker PU, Sarimo J, Orava S, Imhoff AB. Clinical principles in the management of hamstring injuries. Knee Surg Sports Traumatol Arthrosc. 2015;23:2449–56.
Birmingham P, Muller M, Wickiewicz T, Cavanaugh J, Rodeo S, Warren R. Functional outcome after repair of proximal hamstring avulsions. J Bone Joint Surg Am. 2011;93:1819–26.
Carmichael J, Packham I, Trikha SP, Wood DG. Avulsion of the proximal hamstring origin. Surgical technique. J Bone Joint Surg Am. 2009;91(Suppl 2):249–56.
Cohen SB, Rangavajjula A, Vyas D, Bradley JP. Functional results and outcomes after repair of proximal hamstring avulsions. Am J Sports Med. 2012;40:2092–8.
Lempainen L, Sarimo J, Heikkilä J, Mattila K, Orava S. Surgical treatment of partial tears of the proximal origin of the hamstring muscles. Br J Sports Med. 2006;40:688–91.
Moatshe G, Chahla J, Vap AR, Ferrari M, Sanchez G, Mitchell JJ, LaPrade RF. Repair of proximal hamstring tears: a surgical technique. Arthrosc Tech. 2017;6:e311–7.
Pombo M, Bradley JP. Proximal hamstring avulsion injuries - a technique note on surgical repairs. Sports Health. 2009;1:261–4.
Sarimo J, Lempainen L, Mattila K, Orava S. Complete proximal hamstring avulsions: a series of 41 patients with operative treatment. Am J Sports Med. 2008;36:1110–5.
Shambaugh BC, Olsen JR, Lacerte E, Kellum E, Miller SL. A comparison of nonoperative and operative treatment of complete proximal hamstring ruptures. Orthop J Sports Med. 2017;5:2325967117738551.
Sinikumpu JJ, Hetsroni I, Schilders E, Lempainen L, Serlo W, Orava S. Operative treatment of pelvic apophyseal avulsions in adolescent and young adult athletes: a follow-up study. Eur J Orthop Surg Traumatol. 2018;28:423–9.
Lempainen L, Kosola J, Pruna R, Puigdellivol J, Sarimo J, Niemi P, Orava S. Central tendon injuries of hamstring muscles: case series of operative treatment. Orthop J Sports Med. 2018;6:2325967118755992.
Lempainen L, Sarimo J, Orava S. Recurrent and chronic complete ruptures of the proximal origin of the hamstring muscles repaired with fascia lata autograft augmentation. Arthroscopy. 2007;23:441.e1–5.
Folsom GJ, Larson CM. Surgical treatment of acute versus chronic complete proximal hamstring ruptures: results of a new allograft technique for chronic reconstructions. Am J Sports Med. 2008;36:104–9.
Hernesman SC, Hoch AZ, Vetter CS, Young CC. Foot drop in a marathon runner from chronic complete hamstring tear. Clin J Sport Med. 2003;13:365–8.
Street CC, Burks RT. Chronic complete hamstring avulsion causing foot drop. A case report. Am J Sports Med. 2000;28:574–6.
Carmody C, Prietto C. Entrapment of the sciatic nerve as a late sequela of injury to the hamstring muscles. A case report. J Bone Joint Surg Am. 1995;77:1100–2.
Takami H, Takahashi S, Ando M. Late sciatic nerve palsy following avulsion of the biceps femoris muscle from the ischial tuberosity. Arch Orthop Trauma Surg. 2000;120:352–4.
Lempainen L, Sarimo J, Mattila K, Vaittinen S, Orava S. Proximal hamstring tendinopathy: results of surgical management and histopathologic findings. Am J Sports Med. 2009;37:727–4.
Lempainen L. Thesis. Surgical treatment of hamstring injuries and disorders – the clinical spectrum from chronic tendinopathy to complete rupture. Turku: University of Turku; 2009. http://www.doria.fi/bitstream/handle/10024/43989/AnnalesD840Lempainen.pdf.
Barnett AJ, Negus JJ, Barton T, Wood DG. Reattachment of the proximal hamstring origin: outcome in patients with partial and complete tears. Knee Surg Sports Traumatol Arthrosc. 2015;23:2130–5.
Piposar JR, Vinod AV, Olsen JR, Lacerte E, Miller SL. High-grade partial and retracted (<2 cm) proximal hamstring ruptures: nonsurgical treatment revisited. Orthop J Sports Med. 2017;5:2325967117692507.
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Lempainen, L., Kosola, J., Orava, S. (2020). Proximal Hamstring Repair/Reinsertion: Open Surgery Technique. In: Bonin, N., Randelli, F., Khanduja, V. (eds) Hip Preservation Surgery . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61186-9_26
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DOI: https://doi.org/10.1007/978-3-662-61186-9_26
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