Open Proximal Hamstring Repair Using All-Suture Anchors and Tension-Slide Fixation

Proximal hamstring avulsions, often seen in active adults, result from high-energy eccentric loading during hip flexion with knee extension. Open repair remains the gold standard, allowing direct visualization and sciatic nerve protection. Low-profile all-suture anchors have emerged as an alternative to traditional metal or PEEK (polyether ether ketone) devices. This technical note describes a reproducible technique using 3 Q-Fix all-suture anchors (Smith & Nephew, London, England) in a triangular tension-slide configuration. This construct offers strong anatomic fixation with minimal implant burden and reduced bone loss. It is particularly advantageous in cases of tendon retraction or poor tissue quality and is broadly adaptable, including for high-demand populations.