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Reconstruction of Chronic Proximal Hamstring Avulsion Injury Using Quadriceps Allograft: A Technical Note.

Nicolas Lefèvre¹, Hassan Basri Sezer², Ali Alayane¹

¹Clinique du Sport, Paris, France.

Arthroscopy Techniques

|October 24, 2025

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Chronic proximal hamstring tears can be surgically repaired using a fresh-frozen quadriceps tendon allograft when primary repair isn't possible. This technique provides a strong, lengthy graft for better outcomes in complex hamstring injury cases.

Area of Science:

Orthopedic Surgery
Sports Medicine
Regenerative Medicine

Background:

Chronic proximal hamstring ruptures present management challenges due to tendon retraction, scarring, and potential sciatic nerve issues.
Primary surgical repair is often infeasible for chronic, irreparable tears, necessitating graft reconstruction.

Purpose of the Study:

To describe a novel surgical technique for chronic, irreparable proximal hamstring tears.
To detail the use of a fresh-frozen quadriceps tendon allograft for hamstring reconstruction.

Main Methods:

A technical note describing a surgical procedure utilizing a fresh-frozen quadriceps tendon allograft.
The technique involves securing the patellar end of the allograft to the ischial tuberosity with anchors.
The distal portion of the graft is wrapped around the retracted hamstring tendon stump.

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Main Results:

The quadriceps tendon allograft provides adequate length and biomechanical strength for bridging the defect.
The graft fixation method allows secure attachment to the ischial tuberosity.
The technique minimizes the need for extreme knee flexion during the fixation process.

Conclusions:

Fresh-frozen quadriceps tendon allograft is a viable option for reconstructing chronic, irreparable proximal hamstring tears.
This technique offers a robust solution for complex hamstring injuries where primary repair fails.
The described method facilitates secure graft fixation and potentially simplifies the surgical procedure.