Proximal Hamstring Pearls and Pitfalls: Everything from Arthroscopic Repair to Open Reconstruction (AANA19)-Surgical Treatment of Chronic Proximal Hamstring Tendon Tears-Dr. Thomas Youm, M.D.

Surgical Treatment of Chronic Proximal Hamstring Tendon Tears-Dr. Thomas Youm, M.D.

Video Transcription

Video Summary

The discussion focuses on chronic proximal hamstring tendon tears, highlighting diagnosis, surgical options, and outcomes. Chronic tears often go undiagnosed due to subtle symptoms like weakness, cramping, and sciatic nerve irritation, with MRI being the diagnostic gold standard. Surgery involves careful dissection to identify and protect the sciatic nerve, with options including primary repair or allograft reconstruction using an Achilles tendon graft, emphasizing proper tensioning and incision strategy. Postoperative rehab includes bracing and gradual mobilization, with return to sports typically at 6-12 months. Studies show acute repairs generally yield better outcomes and fewer complications than chronic repairs. Sciatic nerve injury is a significant complication. Endoscopic repair offers improved visualization and less invasiveness but is technically demanding and may require conversion to open surgery, especially for chronic, retracted tears or extensive nerve involvement. Surgical approach selection depends on tear chronicity, retraction degree, tendon involvement, and patient demands.

Asset Caption

Instructional Course Lecture: Proximal Hamstring Pearls and Pitfalls: Everything from Arthroscopic Repair to Open Reconstruction

Keywords

chronic proximal hamstring tendon tears

MRI diagnosis

surgical repair techniques

sciatic nerve protection

postoperative rehabilitation