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. 2013 Jun;14(2):83-9.
doi: 10.1007/s10195-013-0226-2. Epub 2013 Feb 9.

Surgical management of chronic proximal hamstring tendinopathy in athletes: a 2 to 11 years of follow-up

Francesco Benazzo  1 , Matteo Marullo, Giacomo Zanon, Cristian Indino, Francesco Pelillo
Affiliations

Surgical management of chronic proximal hamstring tendinopathy in athletes: a 2 to 11 years of follow-up

Francesco Benazzo et al. J Orthop Traumatol. 2013 Jun.

Abstract

Background: Proximal hamstring tendinopathy typically afflicts athletes. The poor knowledge of this pathology can lead to late diagnosis and late treatment, which in chronic cases could be challenging. Surgical treatment could resolve the symptoms and could permit the return to full sport activity also in chronic cases.

Materials and methods: We retrospectively evaluated 17 high-level athletes surgically treated for proximal hamstring tendinopathy. Symptoms lasted for an average of 23 months and were resistive to conservative treatment.

Results: The follow-up period averaged 71 months. Return to run without pain occurred at a mean of 2.4 months (range 1-4) after surgery. All patients returned to sports at their pre-symptom level at a mean of 4.4 months after surgery. Results were excellent in 15 patients (88 %) and good in two patients (12 %). No results were fair or poor.

Conclusions: Surgical treatment to manage chronic proximal hamstring tendinopathy in high-level athletes showed excellent results in terms of relief from symptoms and return to previous sport level.

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Figures

Fig. 1
Fig. 1
Magnetic resonance images of a 27 years old male hurdler with chronic posterior left sub-gluteal pain. a Proton density-weighted coronal image showing tendinosis of proximal left semimembranosus tendon (arrows). b T1-weighted axial image clear defines tendinosis and not tear (arrow). Left sciatic nerve runs immediately lateral to the tendon (asterisk)
Fig. 2
Fig. 2
Intraoperative photograph. After section of the fascia superficialis, the distal edge of the gluteus maximus muscle is retracted; the proximal hamstring tendons are exposed
Fig. 3
Fig. 3
Intraoperative photograph. The sciatic nerve is identified laterally to the hamstring tendons and freed from adhesion
Fig. 4
Fig. 4
Time to return to sport activities after surgery
Fig. 5
Fig. 5
MRI of a 30 years old male long-distance runner 18 months after surgical treatment for left PHT. a Proton density-weighted coronal image showing no abnormal signal intensity of the left proximal hamstring insertion (arrows). The right proximal hamstring tendons present increased signal intensity compatible with PHT (arrowheads). b T2-weighted axial image clear shows no intratendinous structural abnormalities in the left proximal hamstring tendons (arrows). The right side presents signs of PHT (arrowheads). This patient underwent surgical treatment for right PHT four months after having performed the MRI, but he was not considered in this study because of the follow-up inferior to 24 months
See this image and copyright information in PMC

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