The Journal of Hip Surgery 2018; 02(04): 176-188
DOI: 10.1055/s-0038-1676285
Special Section Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Proximal Hamstring Injuries: Review of Operative and Nonoperative Management

Joseph Buckwalter V
1   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
,
Kyle Duchman
1   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
2   Department of Orthopedics, Duke University, Durham, North Carolina
,
Ned Amendola
1   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
2   Department of Orthopedics, Duke University, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

05 April 2018

14 August 2018

Publication Date:
04 December 2018 (online)

Abstract

While uncommon, proximal hamstring injuries can result in significant pain and dysfunction, while also posing considerable treatment dilemmas due to the spectrum of injury that exists. Recent literature suggests that outcomes are improved with acute surgical repair of complete proximal hamstring avulsions, highlighting the importance of timely management of these unique injuries. While chronic repair or reconstruction can result in predictable improvements in pain and function postoperatively, the results are less predictable than acute surgical repair. Nonoperative management should be considered as the initial treatment strategy for patients with proximal hamstring tendinopathy or partial tears, as delayed surgical intervention in this setting has not been shown to significantly affect outcomes. Although current evidence is limited, evolving therapeutic techniques, including biologic injections and endoscopic repair techniques, need to be carefully evaluated to determine their role moving forward. This review aims to provide updated information on the relevant anatomy, mechanism of injury, diagnosis, and management of proximal hamstring injuries, with a specific focus on surgical indications, techniques, and outcomes.