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Review
. 2021 Apr;40(2):339-361.
doi: 10.1016/j.csm.2021.01.003. Epub 2021 Feb 10.

Proximal Hamstring Injuries

Amanda N Fletcher  1 , Jonathan W Cheah  2 , Shane J Nho  3 , Richard C Mather 3rd  4
Affiliations
Review

Proximal Hamstring Injuries

Amanda N Fletcher et al. Clin Sports Med. 2021 Apr.

Abstract

Proximal hamstring injuries can present as chronic tendinosis, acute strain, partial tendinous avulsions, or complete 3-tendon rupture. Nonoperative management for chronic insertional tendinosis and low-grade tears includes activity modification, anti-inflammatories, and physical therapy. Platelet-rich plasma injections, corticosteroid injections, dry needling, and shock wave therapy are newer therapies that also may provide benefit. Surgical indications include complete, proximal avulsions; partial avulsions with least 2 tendons injured with more than 2 cm of retraction in young, active patients; and partial avulsion injuries or chronic tendinosis that have failed nonoperative management. Surgical management entails open primary repair, endoscopic primary repair, or augmentation/reconstruction.

Keywords: Chronic insertional tendinosis; Hamstring; Injury; Proximal hamstring injuries; Rupture; Strain; Tendinopathy; Tendinosis.

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Conflict of interest statement

Disclosure A.N. Fletcher and J.W. Cheah: No conflicts to disclose. S.J. Nho receives research support from AlloSource, Arthrex, Athletico, DJ Orthopedics, Linvatec, Miomed, Smith and Nephew, and Stryker; is a board/committee member of American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America; receives intellectual property royalties from Ossur and Stryker; receives publishing royalties and financial/material support from Springer; and is a paid consultant for Stryker, outside the submitted work. R.C. Mather is a board or committee member of Arthroscopy Association of North America, North Carolina Orthopaedic Association, and International Society of Hip Arthroscopy; receives research support from Reflexion Health and Zimmer; receives intellectual property royalties from Stryker; and is a paid consultant for Stryker, outside the submitted work.

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