Hamstring Tendon Repair
Surgical Reconstruction to Restore Function and Strength After a Hamstring Tendon Tear.
Your hamstrings include a group of three muscles; the semitendinosus, semimembranosus, and biceps femoris, run along the back of your thigh. These muscles are critical for two major movements: hip extension (bending the hip backward) and knee flexion (bending the knee). Injuries to the hamstring tendons, such as tears or proximal hamstring tendon avulsions (where the tendon detaches from the bone), can lead to severe pain, weakness, and impaired mobility, making everyday activities difficult.
In cases of significant injury, surgical intervention like a hamstring tendon repair may be required to restore function and strength.
Hamstring tendon repair (also known as hamstring reattachment or proximal hamstring tendon repair) is the surgical procedure designed to reattach the torn tendon to its original attachment site or repair the damaged muscle fibres and Dr Liddell might recommend this procedure for patients whose hamstring injuries have not improved with conservative treatments, such as physiotherapy, rest, or anti-inflammatory medications.
By undergoing hamstring tendon repair surgery, patients can regain normal function, strength, and the ability to return to sports or physically demanding jobs.
WHEN A HAMSTRING TENDON REPAIR MIGHT BE RECOMMENDED
Hamstring tendon repair surgery may be more effective when performed within the first four weeks after an injury. Early intervention can help reduce the likelihood of complications such as excessive scar tissue formation, chronic pain, and long-term muscle weakness. If the surgery is delayed, the hamstring tendon may shorten or retract, potentially making the procedure more complex. For this reason, early diagnosis and treatment are often preferred.
In some cases, chronic injuries, such as those diagnosed more than four weeks after the initial injury, might still be treated effectively however, these patients may require more advanced techniques, such as tendon grafting.
Dr Liddell will provide a tailored surgical approach based on the specifics of your injury, ensuring that the most appropriate treatment plan is considered for your situation.
THE HAMSTRING TENDON REPAIR SURGICAL PROCEDURE
The surgical procedure itself is performed under general anaesthesia and typically involves the following steps:
A carefully planned incision is made along the back of the thigh or near the buttocks, depending on the location and severity of the injury. The placement of the incision is crucial, as it provides direct access to the injured hamstring tendon while minimising damage to surrounding tissues.
Once the incision is made, Dr Liddell carefully separates the injured hamstring tendons from surrounding scar tissue, muscle fibres, and connective tissue. This process is essential for preparing the tendon for reattachment and ensuring it can glide smoothly after healing. Scar tissue, which often forms after injury, can limit tendon mobility, so removing these adhesions is a key step in the procedure.
For patients with complete hamstring tendon tears, the damaged tendon must be reattached to its original attachment point on the ischial tuberosity, a bony prominence located deep beneath the gluteal fold on the pelvis. Dr Liddell will typically use sutures, anchors, or other specialised surgical devices to securely fasten the tendon back to the bone. The goal is to restore the tendon’s natural attachment, allowing it to function properly during everyday activities such as walking, bending, and even athletic movements.
In cases of chronic hamstring injuries, the tendon may have retracted too far to be reattached directly to the bone. When this happens, tendon grafting may be necessary. This involves using a tendon graft (either from another part of your body or from a donor) to bridge the gap between the torn tendon and the ischial tuberosity. This technique restores the tendon to its proper length and position, allowing for normal function and improved strength after healing. Dr Liddell will discuss the need for tendon grafting in detail if this approach is required for your surgery.
After the tendon is reattached or repaired, the incision is closed with sutures, and the area is dressed to prevent infection. You will be placed in a brace or bandage to immobilise the area and support the tendon as it heals. In most cases, patients spend one night in the hospital for observation before being discharged.
WHAT TO EXPECT DURING RECOVERY FROM A HAMSTRING TENDON REPAIR
Recovery from hamstring tendon repair surgery is a gradual process that requires a combination of rest, immobilisation, and physiotherapy.
Immediately following surgery, you will need to limit weight-bearing activities and may be required to use crutches or a brace for several weeks to protect the repaired tendon.
Physiotherapy typically begins shortly after surgery to help restore range of motion, strength, and flexibility. The rehabilitation process will be tailored to your specific needs and the extent of your injury. Your physiotherapist will guide you through exercises designed to prevent stiffness and promote healing while avoiding excessive strain on the hamstring.
Recovery Timeline:
Initial focus on rest, managing pain, and protecting the repaired tendon with a brace or crutches. Gradual introduction of gentle physiotherapy exercises to restore range of motion.
Progressive strengthening exercises are introduced, with a focus on improving muscle strength and function.
As strength returns, more advanced exercises may be incorporated to prepare for a return to regular daily activities.
Depending on the severity of the injury and surgery, most patients can return to their pre-injury activities, including sports, between 3 and 6 months after surgery.
Hamstring tendon repair surgery has a high success rate, particularly in patients who undergo the procedure soon after the injury. Most individuals regain near-normal strength and function, allowing them to return to pre-injury activities without pain or weakness. Recovery is,however, patient-specific and can depend on factors such as the severity of the injury, age, and adherence to the rehabilitation program.