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Surgical Management of Chronic Proximal Hamstring Avulsion Using Hamstring Allograft
Julio C Gali1, Igor S de Novais1, Leonardo A Carletti1
1Surgery, Faculty of Medical Science and Health, Pontifical Catholic University of São Paulo, Sorocaba, BRA.
Cureus
|November 3, 2025
Summary
Chronic proximal hamstring avulsions cause significant functional impairment, affecting limb control during activities like running. Surgical repair is challenging with tendon retraction, sometimes requiring hamstring allografts for reconstruction.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Rehabilitation
Background:
- Chronic proximal hamstring avulsions are uncommon injuries.
- Late presentation can lead to functional impairment, including reduced eccentric hamstring control.
- Symptoms may include cramping, weakness, instability, and radiculopathy.
Purpose of the Study:
- To review the challenges and potential solutions for managing chronic proximal hamstring avulsions.
- To discuss surgical considerations when significant tendon retraction is present.
- To highlight the role of hamstring allografts in complex cases.
Main Methods:
- Literature review of chronic proximal hamstring avulsions.
- Analysis of surgical techniques for delayed presentations.
- Evaluation of hamstring allograft utilization.
Main Results:
- Significant tendon retraction complicates surgical reconstruction due to scarring and tissue quality.
- Primary repair may not be feasible in chronic cases.
- Hamstring allografts offer a viable option to bridge defects and restore continuity.
Conclusions:
- Chronic proximal hamstring avulsions present unique management challenges.
- Surgical reconstruction requires careful consideration of tendon retraction and tissue quality.
- Hamstring allografts are a valuable tool for restoring function in complex avulsions.
