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Proximal Hamstring Repair – Surgical Tips

Tips from Dr. Busconi

  • Nonoperative
    • reserved for 1-2 tendon tears…look at handouts
  • Gluteal crease incisions

    • remember that it is more lateral than you think
    • vertical incisions only for chronic repairs
  • locate the sciatic and posterior lateral cutaneous n. before doing your repair
  • final repair in 30-40 degrees of flexion,
    • make sure knee gets out to 10 degrees of flexion
    • hinged knee brace locked at 30 degrees of flexion for 6 weeks
    • toe touch weight bearing with crutches
  • Endoscopic proximal hamstring repair

    • do we need it?
    • yes, less morbidity, smaller incisions
    • 3 portal placement (just below tuberosity and then on each side
    • increase risk of NV injury during blind portal placement
    • learning curve
    • technical challenge of passing suture
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