The Endoscopic-to-Open Proximal Hamstring Repair Technique for Chronic, High-Grade Tears
Nicholas J Lemme1, Eric Y Hu1, Jesus E Cervantes1
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, U.S.A.
Arthroscopy Techniques
|September 12, 2025
Summary
This study introduces an endoscopic-to-open technique for proximal hamstring tears, combining endoscopic visualization with open repair benefits. This approach addresses challenges in treating larger tears, improving surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
Background:
- Open repair is the traditional method for proximal hamstring tears.
- Endoscopic approaches offer minimally invasive benefits, including enhanced visualization.
- Challenges remain for large or retracted tears with purely endoscopic methods.
Purpose of the Study:
- To describe and evaluate the endoscopic-to-open technique for proximal hamstring tear repair.
- To combine the visualization advantages of endoscopy with the access of open surgery.
Main Methods:
- Patients are positioned prone with knee flexion.
- Posterior and posterolateral portals are used for endoscopic preparation (ischial bursectomy, footprint preparation, anchor placement).
- An interposing skin incision allows for open tendon access, mobilization, and repair using a docking technique.
Main Results:
- The technique allows for ischial tuberosity preparation via endoscopy.
- It provides open surgical access for tendon mobilization and repair tensioning.
- Final arthroscopic visualization ensures neurovascular structure protection.
Conclusions:
- The endoscopic-to-open technique offers a hybrid approach for proximal hamstring tears.
- It leverages endoscopic visualization for preparation and open access for complex repairs.
- This method may enhance treatment for challenging proximal hamstring avulsions.
