Hamstring Repair Surgery

While hamstring strain is a very common problem in sporting population, the proximal hamstring tear is an uncommon injury. Majority of them are likely to be partial tears, however a small number of them are complete tears with retraction of the proximal hamstrings. Often the tear would be due to avulsion of the periosteum of the bone along with the proximal hamstring muscle.

Diagnosis

With good physical examination, the bruising, gap in the hamstring tendon and free SLR without the restraint to passive stretch are indicative of the the proximal hamstring tear.

X-ray. X-ray is performed and is useful to rule out any bone injuries. However, the hamstring muscle tear is not visible on the X-ray.

MRI Scan. MRI Scan is the gold standard investigation to identify the type and extent of the hamstring tear. In addition, it helps to assess the retraction of the tendon.

Treatment

First Aid for proximal hamstring tear involves the typical R.I.C.E therapy for the first week.

Rest. It is important to minimize walking around.

Icepacks. Cold packs 3 to 4 times a day helps reduce the swelling

Compression. Thigh compression band is sufficient to help with compression.

Elevation. Keeping it elevated on a pillow when resting helps.

Chronic Partial tear of Proximal Hamstrings

Non-healing partial tears can be treated with PRP injection. In patients with no improvement with this treatment and in those with high grade 2 or grade 3 tears, surgery becomes necessary.

Proximal Hamstring Repair Surgery

Proximal hamstring needs fixation back to the ischial bone.
Fiber-wires are used to stitch and pull the muscle tendon back to the bone.
Bone is freshened up first to create the cancellous bone bed to help grow the tendon back to the bone,
Fixation is by using either PEEK (high grade polymer) or Bio Suture anchors inserted into the ischial bone.
The fixation technique is called speed-bridge technique which helps compress the tendon to the bone.