Proximal Hamstring Tears: Endoscopic Hamstring Repair

Repair of Retracted Hamstring Tears with Hamstring Pulley Technique and Inferomedial Portal

Endoscopic repair of hamstring tears is well described in the literature, but endoscopic management for significantly retracted hamstring tears is not well described. Currently, repairing a hamstring tendon that has retracted 8 cm or more from the footprint on the ischial tuberosity is performed as an open procedure. The technique described here details endoscopic repair of retracted hamstring tears using a suture pulley mechanism and an inferomedial portal.

Endoscopic Proximal Hamstring Tendon Repair With Knotless Suture-Bridge Technique

Symptomatic proximal hamstring tendon tears are typically repaired surgically, with open incision and knot-tying technique. An endoscopic, knotless, suture-bridge repair technique is presented. Potential advantages include knotless simplicity, compression over a broad zone to improve tendon-bone healing, and decreased pain secondary to elimination of knots and the open incision and approach.

All-Endoscopic Modified Krackow Suture for Proximal Hamstring Repair

Surgical repair of proximal hamstring injuries can relieve pain and restore lower extremity function in active individuals. Whereas traditional surgical techniques are performed via an open approach, more recent endoscopic proximal hamstring repair techniques have proven safe, effective, and potentially associated with fewer complications than open repair. One theorized disadvantage of existing endoscopic techniques is reduced security at the suture-tendon interface, as compared to open surgery, during which a running suture technique, such as a Krackow stitch, may be employed. In this article, we present a technique for increasing suture purchase by performing an all-endoscopic, running, locking stitch during proximal hamstring repair.

Endoscopic Partial Proximal Hamstring Repair

The contemporary treatment of hamstring avulsions has been evolving, as more patients are being identified as having persistently symptomatic partial hamstring tears recalcitrant to nonoperative treatment. The endoscopic hamstring repair allows surgeons improved visualization of the footprint, as well as safe dissection of the sciatic nerve. The present technique article provides a step-by-step technical note to allow for safe and effective surgical treatment of partial hamstring tears.