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Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes

2021 Congress Paper Abstracts

Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes

Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Steven Cecchi, BSc (Hons), MBBS, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter T. Annear, FRACS(Orth), AUSTRALIA

Orthopaedic Research Foundation of Western Australia / Perth Orthopaedic & Sports Medicine Centre, Perth, Western Australia, AUSTRALIA

2021 Congress   ePoster Presentation     Not yet rated


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Summary: Surgical Management Of Intramuscular Hamstring Biceps Tendon Injuries Leads To successful return to same level of sport without reinjury


Intra-muscular hamstring tendon injuries are recognised as a significant hamstring injury, particularly in high-level sport. These injuries demonstrate longer return to sport, but more significantly they are associated with a high risk of recurrent injuries. This can lead to repetitive loss of game-time, inferior sporting performance and psychological inhibition to peak sporting function.


Patients were identified retrospectively using surgeon logbooks and filtered via hospital coding. Once patients were identified their clinical notes and imaging were reviewed to confirm that all patients had injuries to the intramuscular portion of the distal aspect of the proximal biceps femoris tendon. All imaging was reviewed by an experienced musculoskeletal radiologist to confirm diagnosis. Surgery for such injuries was indicated in high-level athletes presenting with acute hamstring injuries. All patients were operated on within 4 weeks. Outcomes included Tegner scores, return to sport, Lower Extremity Functional Score (LEFS), current hamstring symptoms and complications including reinjury.


13 injuries in 11 athletes were found. All were male. Mean age was 26.8 (21-50). Five occurred in professional athletes, six in semi-professional and one in a recreational athlete. Return to sport occurred at 3.5 (SD 1.4) months. Pre-injury Tegner 9.2 (SD 1.3), maximum post-injury Tegner 9.2 (SD 1.3) and current Tegner 9.2 (SD 1.3) showed no difference. No patient had any further hamstring injuries or re-operations. Maximum LFES was achieved by all. All patients were satisfied/very satisfied with their outcomes.


Surgical management of intra-muscular hamstring tendon injuries leads to high PROMs and satisfaction with early return to sport and negligible post-operative hamstring symptoms. There were no reinjuries or surgical complications. Athletes who suffer high grade or recurrent hamstring strains should be investigated for a central tendon injury with MRI, and considered for early surgical repair.

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