Anatomic Reinsertion of Isolated Proximal Semimembranosus Tendon Avulsion in Athletic Population: A Technical Note

Acute hamstring tears are common athletic injuries. Most of these injuries involve muscle belly strain or affect the myotendinous junction. These lesions can often be managed nonoperatively, resulting in a satisfactory functional outcome after an appropriate rehabilitation program. However, acute proximal hamstring avulsion injury occurs less commonly, and early surgical reinsertion is recommended to avoid long-term functional disabilities and to allow a successful return to sport. In this article, we describe a step-by-step surgical technique for reinsertion of proximal isolated semimembranosus tendon avulsion in the athletic population, highlighting the significance of the preoperative radiologic cobra-sign diagnosis and its intraoperative manifestation in this rare injury.