Surgical Management of Chronic Proximal Hamstring Avulsion Using Hamstring Allograft

Chronic proximal hamstring avulsions are uncommon injuries that may result in significant functional impairment. Late presentation often includes reduced control of the affected limb during the eccentric phase of hamstring activation, particularly noticeable during activities such as running or brisk walking. Additional complaints may include posterior thigh cramping, subjective muscle weakness, sensations of instability or "giving way," and symptoms consistent with sciatica or radiculopathy. When significant tendon retraction is present, surgical reconstruction can be technically challenging due to factors such as tendon scarring, compromised tissue quality, and increased distance from the ischial tuberosity. In cases where primary repair is not feasible, hamstring allografts may be employed to bridge the defect and re-establish continuity of the musculotendinous unit.