Cohen and Bradley review the diagnosis and surgical management of acute complete proximal hamstring ruptures from the ischial tuberosity, synthesizing small published series and presenting the authors' own treatment algorithm and operative technique for deciding when and how to repair these injuries.
When MRI confirms two or more proximal hamstring tendons avulsed with ≥2 cm retraction in an active patient under 50, early surgical repair (within days) is preferred — delays allow tendon-to-sciatic nerve scarring that complicates repair and worsens outcomes.
Use the five-anchor 'X' configuration on the lateral ischial tuberosity and clear the patient for sport only when isokinetic strength hits 80% of the contralateral side.
Cohen and Bradley review the diagnosis and surgical management of acute complete proximal hamstring ruptures from the ischial tuberosity, synthesizing small published series and presenting the authors' own treatment algorithm and operative technique for deciding when and how to repair these injuries.
When MRI confirms two or more proximal hamstring tendons avulsed with ≥2 cm retraction in an active patient under 50, early surgical repair (within days) is preferred — delays allow tendon-to-sciatic nerve scarring that complicates repair and worsens outcomes.
Use the five-anchor 'X' configuration on the lateral ischial tuberosity and clear the patient for sport only when isokinetic strength hits 80% of the contralateral side.