Combined endoscopic and mini-open repair of chronic complete proximal hamstring tendon avulsion: a novel approach and short-term outcomes

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Research

Background:

• Chronic complete retracted proximal hamstring avulsion (PHA) presents a significant clinical challenge.
• Surgical repair options for chronic PHA are evolving, with a need for effective techniques.
• Combined endoscopic and mini-open repair (CEMR) is a novel approach for managing these complex injuries.

Purpose of the Study:

• To evaluate the functional outcomes of a novel combined endoscopic and mini-open repair (CEMR) for chronic complete retracted proximal hamstring avulsion (PHA).
• To assess patient satisfaction, muscle strength, and postoperative complications following CEMR.
• To determine the safety and efficacy of CEMR in treating chronic PHA.

Main Methods:

• Retrospective case series of patients undergoing CEMR for chronic PHA between July 2015 and September 2019.
• Minimum 1-year follow-up with evaluation using the Perth Hamstring Assessment Tool (PHAT).
• Assessment of muscle strength, subjective satisfaction, and complications in the operated leg compared to the uninjured leg.

Main Results:

• Six patients (five males, mean age 48 years) with a mean injury-to-surgery time of 12 months were evaluated.
• At a mean follow-up of 28 months, the average PHAT score was 73, indicating good functional outcome.
• Mean subjective activity level improved from 34% pre-surgery to 81% post-surgery, with no significant difference in muscle strength between legs.

Conclusions:

• Combined endoscopic and mini-open repair (CEMR) is a viable and safe surgical option for chronic complete proximal hamstring tears.
• The technique demonstrates good to excellent short-term functional outcomes for patients with chronic PHA.
• CEMR facilitates significant improvement in patient activity levels and subjective function.