Endoscopic Repair of Proximal Hamstring Avulsion

Hamstring muscle injuries are common in athletes and mostly consist of sprains at the myotendinous junction, which often respond well to conservative treatment. Proximal hamstring avulsion injuries, though less common, can be severely debilitating. This injury is often seen in water skiers but has been described in many other sports and in middle-aged patients. Complete avulsions in young and active individuals do not respond well to conservative treatment and may require surgical repair. In contrast, many partial tears may be treated nonoperatively. However, when symptoms continue despite a trial of extensive therapy, surgery may be warranted. Traditional surgery for proximal hamstring repair is performed with the patient in the prone position with an incision made longitudinally or along the gluteal fold, followed by identification of the torn tendons and fixation to the ischial tuberosity. We describe a novel surgical technique for endoscopic repair of proximal hamstring avulsion injuries.