Endoscopic Repair of a Partial Undersurface Proximal Hamstring Tendon Tear.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Minimally Invasive Procedures

Background:

• Proximal hamstring tendon injuries are common in athletes.
• Open repair with suture anchors is the traditional surgical standard.
• Endoscopic techniques offer potential for reduced complications and high patient satisfaction.

Purpose of the Study:

• To describe a minimally invasive endoscopic technique for repairing proximal hamstring undersurface concealed crescentic injuries (HUCCIs).
• To present the HUCCI-X repair technique using interlinked knotless suture anchors.

Main Methods:

• A prone patient position with leg extension and abduction.
• Use of two primary portals for visualization and anchor placement.
• Endoscopic identification, sciatic nerve mobilization, and repair using 4 interlinked knotless anchors in an X-formation.

Main Results:

• Endoscopic proximal hamstring repairs show significant improvement in patient-reported outcomes.
• Outcomes are equivalent to traditional open repair techniques.
• Literature reports a 77% to 95% return to sport rate after endoscopic repair.

Conclusions:

• The HUCCI-X technique is a novel, safe, and effective endoscopic method for repairing undersurface proximal hamstring tears.
• This minimally invasive approach combines benefits of reduced perioperative complications with secure repair.
• Further research is warranted to evaluate long-term patient outcomes.