Acute Surgical Repair of Simultaneous Bilateral Proximal Hamstring Tendon Avulsion

Abstract

Case: Proximal hamstring tendon avulsions are rare injuries that can be successfully treated with surgical intervention. However, there are limited reports on the surgical and postoperative management of patients with bilateral avulsions. We report a 54-year-old male gym teacher with acute bilateral proximal hamstring 3-tendon nonbony avulsions who underwent simultaneous surgical repairs and a unique postoperative rehabilitation course. At 1-year clinical follow-up, the patient demonstrated significant improvements in activity levels and functionality, with no complications. Conclusion: Bilateral proximal hamstring 3-tendon nonbony avulsions can be successfully treated with a simultaneous surgical repair and a modified postoperative rehabilitation course.

Staged Repair of Simultaneous Bilateral Proximal Hamstring Rupture and 2 Year Outcome

“…A recent report presented on simultaneous bilateral proximal hamstring tear that was treated with simultaneous bilateral surgical repair and demonstrated that while simultaneous repair may have certain advantages such as a single surgical encounter and decreased anesthesia burden, it may not be appropriate for all patients because it presents several unique challenges for the surgeon, patient, and therapist 8 . The patient reported severe levels of pain and physical limitations early in their rehabilitation that were attributed to the simultaneous approach 8 . Such limitations may not be tolerable for all patients.…”

“…In unilateral, proximal hamstring injuries, time from injury to surgical repair is an important consideration. Studies have shown increased complications associated with delayed repair and better outcomes associated with acute repair in more active patients 8,[11][12][13] . In patients with delayed presentations, simultaneous repair may afford improved time to surgery.…”

“…Surgical treatment of such injuries presents several unique challenges, and staged repairs may be indicated for certain patients. There is limited literature about the prevalence or treatment of these injuries [6][7][8] . To the best of our knowledge, there have been no reported surgical outcomes after staged repair of bilateral, simultaneous proximal hamstring injuries.…”