# Surgical Management of Chronic Proximal Hamstring Avulsion Using Hamstring Allograft

## TL;DR

This paper discusses the surgical treatment of chronic hamstring injuries using donor tissue to restore muscle function.

## Contribution

The paper introduces the use of hamstring allografts for reconstructing chronic proximal hamstring avulsions when primary repair is not possible.

## Key findings

- Chronic proximal hamstring avulsions can lead to functional impairment and sciatica-like symptoms.
- Surgical reconstruction using hamstring allografts is a viable option when primary repair is not feasible.
- Tendon retraction and tissue degradation complicate surgical repair in chronic cases.

## Abstract

Chronic proximal hamstring avulsions are uncommon injuries that may result in significant functional impairment. Late presentation often includes reduced control of the affected limb during the eccentric phase of hamstring activation, particularly noticeable during activities such as running or brisk walking. Additional complaints may include posterior thigh cramping, subjective muscle weakness, sensations of instability or "giving way," and symptoms consistent with sciatica or radiculopathy. When significant tendon retraction is present, surgical reconstruction can be technically challenging due to factors such as tendon scarring, compromised tissue quality, and increased distance from the ischial tuberosity. In cases where primary repair is not feasible, hamstring allografts may be employed to bridge the defect and re-establish continuity of the musculotendinous unit.