13/09/2026
Proximal hamstring avulsion: when delayed treatment turns a repair into a reconstruction.
Complete avulsion of the proximal hamstring tendons from the ischial tuberosity can cause substantial functional impairment. When surgery is indicated, timely reattachment matters. Delaying treatment can lead to tendon retraction, making subsequent surgery significantly more challenging.
A chronic injury cannot always be treated in the same way as an acute avulsion. Direct reattachment may no longer be possible, and reconstruction may be necessary instead of primary repair.
The illustration below shows a reconstruction using an Achilles tendon allograft to bridge the defect between the retracted hamstring tendons and their attachment on the ischial tuberosity.
In this case, after a six-month wait for surgery, reconstruction was required. Following the procedure, the patient regained normal function and, most importantly, was able to return to physically demanding work.
An important reminder: timely assessment and appropriate treatment are essential—not only for restoring anatomy, but also for helping patients regain their independence and livelihood.