Review of Hamstring Injury and RepairMild to moderate strains of muscles such as the hamstrings are fairly common among athletes. This type of injury can be treated with conservative care and don't usually need surgery. But results are best if surgery is done when there's a complete rupture of the muscle.
In this report, two orthopedic surgeons share their experience and knowledge of hamstring ruptures. In all cases, the hamstring tendon pulled away from the pelvic bone. The hamstrings attach to the ischial tuberosity. This is the boney bump you can feel when you are sitting.
When tendons rupture, they often pull away from the bone along with a small piece of bone. Surgery to reattach the tendon and the bone fragment helps restore function. Athletes may even be able to return to high-level play in sports.
It isn't always easy to tell when the hamstrings have been strained versus ruptured. Many injured athletes notice a large bruise along the back of the thigh about a week after the injury. They walk with a stiff-legged pattern to avoid using the hamstring muscle to bend the hip and knee.
The diagnosis is usually made with an MRI. MRIs show how much soft-tissue injury is present. They also show how much of the tendon is ruptured (partial versus complete). If there's a complete rupture, the MRI shows how far the muscle has retracted or pulled away from its attachment.
The surgeon needs all this information before operating. The authors describe the surgical method they use to repair hamstring ruptures involving two or three tendons.
The tendons are reattached to the bone with suture anchors. The surgeons place five sutures in an X pattern. This method helps avoid stitches bunching up the tendon where it attaches to the bone.
Patients wear a special brace made just for this injury. Following a rehab program, many athletes are able to return to play. This usually occurs between six and nine months after the surgery. Most players are able to return to their previous level of sports participation. If surgery is delayed or not done at all, there is a loss of function and strength.
Steven Cohen, MD, and James Bradley, MD. Acute Proximal Hamstring Rupture. In Journal of the American Academy of Orthopaedic Surgeons. June 2007. Vol. 15. No. 6. Pp. 350-355.
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