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Dr. Pradyumna R carefully evaluate your conditions and symptoms associated to your hip pain and hip injuries, based on the diagnostic report and scan he would suggest if so, you are a candidate for Proximal Hamstring Repair procedure for torn proximal hamstring by sewing the torn part of the hamstring tendon back to the bone using tiny suture-anchors, he is an highly experienced hip treatment specialist provides diagnosis as well as surgical and nonsurgical treatment options at Bangalore Orthopaedic Clinic, in BTM Layout, Bangalore.

If you have any queries or would like to schedule an appointment for Proximal Hamstring Repair procedure or hip pain or hip injury treatment consultation please call +919113025188.

Damage to the hamstring muscles can a debilitating, painful condition and can be associated with chronic pain. Some hamstring injuries generally occurring in the middle of the muscle belly, may heal completely without the need for surgery. However, in a few cases where the hamstrings are injured at the top end, the tendon can pull off the bone. In such cases, surgery is usually recommended to reattach the damaged tendons. Proximal Hamstring Repair is a surgical procedure for treating the proximal hamstring tear. The repair surgery aims to help in regaining the support to the femur and enable us to extend and flex our legs.
A proximal hamstring injury can be a complete tendon rupture or incomplete/partial tears. When it happens in the teen-age patients, the bone with tendon attached is often pulled away or fractured from the pelvis (ischium). However, in mature and adult patients, the tendon is usually pulled away or tears off the bone of the ischium at its attachment point. Occasionally the tendon may tear in its mid-substance leaving a part of tendon still attached to the bone. Often this type of injury is a partial tear.

Proximal hamstring injuries most commonly seen in 3 distinct population studies are:

  • Adolescents: Skeletally not mature, can avulse the hamstring origin with a fragment of bone from the ischium.
  • Young, skeletally mature, athletic individuals.
  • Older patients: Usually in their 50s with sedentary lifestyles or participate in recreational sports.

The three grades of hamstring injury are:

  • Grade I – Strain: A mild muscle strain, usually recover in a few days.
  • Grade II – Partial tear: A partial muscle tear.
  • Grade III – Severe tear: A complete muscle tear or tear of an attachment. This may take weeks or months to heal.
You may experience different symptoms depending upon the severity of your injury as listed below.

Grade 1 symptoms:

  • Sudden, radiating pain in the back of your thigh.
  • Though your strength is not affected, it will be hard to move your leg.

Grade 2 Symptoms:

  • Very painful feeling in the thighs
  • Swelling of thighs
  • Bruising visible in the affected area
  • Loss of strength in your leg.

Grade 3 Symptoms:

  • Worse pain in the thighs
  • Tenderness in thighs
  • Swelling and bruising.
  • You might have felt a popping sensation when the injury happened.
  • Bump or knot in your thigh area.
  • Spasms.
  • Muscle stiffness
  • You may feel a gap in the muscle by touching it.
  • The back of the leg will feel tight

Your physician may conduct some tests and investigations based on your signs and symptoms. Diagnostic tests are crucial for an effective treatment plan and some of the investigations include:

Physical examination: Your physician may test the tenderness and examine the swelling and bruising around your hamstring to assess the level of damage.

Imaging tests: Sometimes you may have to take a magnetic resonance imaging test (MRI) for your surgeon to decide the treatment plan.

After surgery, you will be given painkillers to keep you comfortable. You must rest lying on your back with a pillow under the knees, to allow the hamstring to be in a relaxed position. You may have to use crutches and put only a small amount of weight on the ball of the foot to maintain some flexion in the knee. At the post-operative review at 2 weeks, stitches will be removed and gentle and controlled hip and knee movement will be advised and as you are comfortable, crutches can be gradually weaned. At 6 weeks, some resisted hamstring activity will be recommended, and possibly a return to light running at 3-4 months. Return to competitive sports may be considered after 6 months. All these timeframes are guidelines and may vary according to the injury and the individual.
Every surgery has some risks and complications. A few complications associated are:
  • Superficial infections
  • Deep wound infections
  • Rerupture
  • Weakness
  • Sitting pain
  • Neuropraxia (injury to the sciatic nerve)
  • Weakness and difficulty sitting
  • Hamstring deformity
  • Scarring
Proximal hamstring repair usually improves outcomes in both acute and chronic injuries. Chronic injuries can lead to muscle atrophy and fibrosis, thereby increasing the difficulty of the repair. When performed in an acute setting, the complications and ruptures of proximal hamstring repair are lower.

Proximal hamstring ruptures can now be treated by arthroscopic procedure. This allows multiple benefits with proper treatment and good functional results in most patients. However, it is important to realize that some patients may not be candidates for these procedures as a result of several factors including a larger tear, prior surgery, and many other factors.

Advantages include:

  • Smaller incisions
  • Less bleeding during surgery
  • Less scarring
  • Faster recovery
  • Reduced risk of infection
  • Reduced risk of complications
  • Comfortable rehabilitation