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"Scopen" Scope to Open Hamstring Repair.

Lakshmanan Sivasundaram¹, Mario Hevesi¹, Morgan W Rice¹

¹Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA.

Video Journal of Sports Medicine

|May 1, 2025

Summary

This summary is machine-generated.

Proximal hamstring injuries, though less common than distal ones, are increasingly treated with surgical repair. This study details a combined open and endoscopic technique for these challenging injuries, offering potential for improved outcomes.

Keywords:

general sports trauma hip arthroscopy hip/pelvis/thigh muscle injuries waterskiing/wakeboarding

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Area of Science:

Orthopedic Surgery
Sports Medicine
Musculoskeletal Research

Background:

Proximal hamstring injuries represent 12% of all hamstring injuries.
Surgical repair for proximal hamstring tears is becoming more common.
Indications for surgery include 2+ torn tendons and >2 cm retraction.

Purpose of the Study:

To describe a combined open and endoscopic surgical technique for proximal hamstring avulsion.
To highlight the advantages of this hybrid approach over purely open or endoscopic methods.

Main Methods:

A combined technique using posterior and posterolateral portals.
Identification and protection of the posterior femoral cutaneous nerve (PFCN) and sciatic nerve (SN).
Ischial tuberosity preparation with decortication and double-loaded anchor placement.

Main Results:

No outcome studies on the combined technique exist yet.
Potential complications include nerve issues, re-rupture, infection, and DVT.
Significant postoperative improvements are noted for isolated open/endoscopic repairs.

Conclusions:

The combined approach offers improved visualization and nerve preservation compared to open surgery.
It accommodates greater retraction (>4 cm) and chronic tears compared to endoscopic methods.
This technique provides a versatile option for complex proximal hamstring avulsions.