Endoscopic Repair of Proximal Hamstring Insertion With Sciatic Nerve Neurolysis

Castillo-de-la-Peña, Jose; Wong, Ivan

doi:10.1016/j.eats.2021.12.038

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Endoscopic approaches are indicated for partial hamstring avulsions and those with minimal retraction, with the tendon remaining under the gluteus maximus (Table 5, Figure 6). 22,32,39,101 Open approaches are preferred for complete and chronic tears, particularly those with more retraction (Table 5). A combination of endoscopic and open techniques has also been described.…”

Section: Proximal Hamstring Injuriesmentioning

confidence: 99%

“…Although sciatic nerve neurolysis has been described, no data are available regarding whether this results in a benefit or decrease in postoperative neurologic complications. 22,74 Nevertheless, close attention to the sciatic nerve is critical during surgical repair, and care should be taken to ensure it is free of tethers at the end of the case.…”

Section: Operative Treatment—technique Decision-making and Outcomesmentioning

confidence: 99%

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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: Proximal Hamstring Injuriesmentioning

confidence: 99%

Section: Operative Treatment—technique Decision-making and Outcomesmentioning

confidence: 99%

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

et al. 2023

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“…Sciatic neurolysis is performed if there are preoperative symptoms consistent with nerve tethering. 10 …”

Section: Patient Evaluation and Imagingmentioning

confidence: 99%

Endoscopic Proximal Hamstring Tendon Repair With Knotless Suture-Bridge Technique

Hsu,

Wilhelm

2023

Arthroscopy Techniques

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“… 8 On the other hand, an endoscopic technique offers a minimally invasive approach and is typically indicated for patients with partial avulsions, those with minimal retraction, and those where the tendon remains under the gluteus maximus. 6 , 9 , 10 While exposure is limited, paradoxically, visualization may be improved, particularly of the hamstring footprint on the ischium, as this may be a difficult location to view directly in larger patients. Differences in outcomes continue to be analyzed, and are currently limited in the literature, with most analyses reporting no differences between the 2 approaches.…”

Section: Introductionmentioning

confidence: 99%