Allograft reconstruction for symptomatic chronic complete proximal hamstring tendon avulsion.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Regenerative Medicine

Background:

• Complete proximal hamstring tendon avulsion is a rare injury causing significant disability in young athletes.
• Delayed surgical reattachment is feasible if the tendon remains mobile.
• Primary repair may not be possible due to tendon retraction.

Observation:

• Two 30-year-old patients with chronic proximal hamstring avulsion underwent reconstruction using Achilles tendon allograft.
• Patients experienced severe hamstring weakness and activity limitations for over two years prior to surgery.
• Post-surgery, patients were immobilized for 8 weeks, followed by physical therapy and progressive weight-bearing.

Findings:

• Both patients demonstrated improved function and returned to a more active lifestyle, including sports participation.
• Follow-up over two years showed significant functional gains compared to pre-operative status.
• Isokinetic strength testing revealed persistent weakness on the operated side in both patients.

Implications:

• Interpositional allograft reconstruction is a viable salvage option for chronic proximal hamstring avulsion when primary repair is not possible.
• This surgical approach can restore a meaningful level of function, enabling return to athletic and recreational activities.
• Complete return to pre-injury function may not be achieved, highlighting the need for realistic patient expectations.