Distal Hamstring Muscle Injuries

Matthews, John; Sonnier, John Hayden; Prodoehl, John P.; Saucedo, Samuel T.; Avendano, John P; Johns, William; Freedman, Kevin B.; Ciccotti, Michael G.; Cohen, Steven B.

doi:10.2106/jbjs.rvw.21.00215

Cited by 2 publications

(2 citation statements)

References 46 publications

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“…For distal injuries, it is important to distinguish which tendon is involved. 70 Distal biceps femoris injuries tend to be managed surgically (Table 4). 57 In contrast, partial tears of the distal semimembranosus and distal semitendinosus may be initially managed nonoperatively, including rest and activity modification, ice, and NSAIDs.…”

Section: Distal Hamstring Injuriesmentioning

confidence: 99%

Hamstring Injuries: A Current Concepts Review: Evaluation, Nonoperative Treatment, and Surgical Decision Making

et al. 2023

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The purpose of this current concepts review is to highlight the evaluation and workup of hamstring injuries, nonoperative treatment options, and surgical decision-making based on patient presentation and injury patterns. Hamstring injuries, which are becoming increasingly recognized, affect professional and recreational athletes alike, commonly occurring after forceful eccentric contraction mechanisms. Injuries occur in the proximal tendon at the ischial tuberosity, in the muscle belly substance, or in the distal tendon insertion on the tibia or fibula. Patients may present with ecchymoses, pain, and weakness. Magnetic resonance imaging remains the gold standard for diagnosis and may help guide treatment. Treatment is dictated by the specific tendon(s) injured, tear location, severity, and chronicity. Many hamstring injuries can be successfully managed with nonoperative measures such as activity modification and physical therapy; adjuncts such as platelet-rich plasma injections are currently being investigated. Operative treatment of proximal hamstring injuries, including endoscopic or open approaches, is traditionally reserved for 2-tendon injuries with >2 cm of retraction, 3-tendon injuries, or injuries that do not improve with 6 months of nonoperative management. Acute surgical treatment of proximal hamstring injuries tends to be favorable. Distal hamstring injuries may initially be managed nonoperatively, although biceps femoris injuries are frequently managed surgically, and return to sport may be faster for semitendinosus injuries treated acutely with excision or tendon stripping in high-level athletes.

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Section: Distal Hamstring Injuriesmentioning

confidence: 99%

Hamstring Injuries: A Current Concepts Review: Evaluation, Nonoperative Treatment, and Surgical Decision Making

et al. 2023

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“…Distal hamstring injuries, although relatively rare, can potentially keep an athlete out of action for an extended period and result in difficulties returning to pre-injury level [24,25]. These injuries can range from minor muscle strains or partial tears to complete tears of the musculotendinous junction or avulsions at the insertion site on the tibia or fibula [6].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of distal hamstring tendon injuries yield a higher return‐to‐sports rate: A systematic review

Marín Fermín,

Aminake,

Vasiliadis

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study is to compare the patient‐reported outcomes and return to sports of the conservative and surgical treatment of distal hamstring tendon injuries.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, two reviewers searched PubMed, Scopus and Virtual Health Library databases in January 2023. Clinical studies evaluating conservative or surgical management outcomes of distal hamstring tendon injuries were considered eligible for this systematic review if predefined criteria were fulfilled: (1) published in English or Spanish; (2) evaluated any of the following: patient‐reported outcomes, return‐to‐sports rate (RTS‐R) or return‐to‐sports time (RTS‐T). Data were presented in tables using absolute values from individual studies and derived pooled percentages.ResultsEighteen studies were included for 67 patients and 68 distal hamstring tendon injuries. Initially, 39 patients (58.2%) underwent surgical treatment, whereas 28 (41.8%) were treated conservatively. Among conservative treatment patients, 15 failed and had to be operated on (53.6%), all with distal semitendinosus tendon injuries. Anchor fixation was the technique of choice in 20 lesions (36.4%), tenodesis in 16 (29.1%), tenectomy in 14 (25.5%) and sutures were preferred in five (9%). Thirteen out of 28 patients (46.4%) undergoing initial conservative treatment returned to sports at a mean of 3.6 months (range 1 week to 12 months), in contrast to surgical treatment, in which 36 out of 39 patients (92.3%) returned at a mean of 4.2 months (range 6 weeks to 12 months). Additionally, 14 of 15 patients (93.3%) converted to surgical treatment after failed conservative treatment returned to sports at a mean of 7.6 months after injury.ConclusionInitial surgical treatment of distal hamstring tendon injuries yields a high RTS‐R (92.3%) at a mean of 4.2 months. Furthermore, 15 out of 28 patients (53.6%) initially treated conservatively had to be operated on, delaying the RTS‐T (mean 7.6 months after injury) without affecting their RTS‐R.Level of EvidenceIV.

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Distal Hamstring Muscle Injuries

Cited by 2 publications

References 46 publications

Hamstring Injuries: A Current Concepts Review: Evaluation, Nonoperative Treatment, and Surgical Decision Making

Hamstring Injuries: A Current Concepts Review: Evaluation, Nonoperative Treatment, and Surgical Decision Making

Surgical treatment of distal hamstring tendon injuries yield a higher return‐to‐sports rate: A systematic review

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