Surgical Repair of Complete Proximal Hamstring Tendon Rupture

Abstract

Background: Complete proximal hamstring tendon rupture is a rare injury associated with significant functional loss. Nonoperative treatment has proven inadequate in returning patients to their previous activity level. Purpose: We wanted to describe the outcome of primary surgical repair of the proximal hamstring tendon avulsion. Study Design: Retrospective cohort study. Methods: Between 1994 and 1999, 11 patients (4 women and 7 men) with an average age of 41.5 years (range, 21 to 51) had a diagnosis of complete proximal hamstring tendon rupture based on mechanism of injury, physical examination, and radiographic assessment. All underwent a single operation followed by standard postoperative physical therapy. At the latest follow-up (average, 34 months), patients completed a questionnaire regarding such outcome parameters as pain, function, leg control, stiffness, return to activity, and overall satisfaction. Results: Isokinetic muscle testing revealed an overall average of 91% return of hamstring muscle strength. Ten of 11 patients were satisfied with the result, and 7 of 9 athletically active patients were able to return to sport an average of 6 months (range, 3 to 10) after surgery. No difference between early and late repairs was identified in regard to functional outcome or return to sport. Conclusions: Satisfactory results can be achieved with both early and late hamstring tendon repairs in a majority of cases with surgical repair.