Functional Outcomes and Return to Sport After Surgical Repair of Complete Proximal Hamstring Avulsions in Recreational Athletes: A Retrospective Case Series
Journal of ISAKOS: joint disorders & orthopaedic sports medicine · 2026
Hamstring avulsion repair got everyone back to sport, but only 1 in 3 got back to their old level, and a third had lasting numbness.
Studien
Retrospective case series, n=11 recreational athletes with complete or severely retracted proximal hamstring avulsions treated with open surgical repair at a single center.
Vad de fann
All 11 patients returned to sport (mean 5.1 months), but only 36.4% returned to their preinjury sporting level; median LEFS was 96.3% of maximum, mean PHAT 92.3±6.5, SF-36 PCS 62.7 and MCS 50.7, while persistent sensory/numbness symptoms remained in 36.4% at final follow-up.
Granskningen
This is Level IV evidence with no comparator group (no conservative-management or historical control arm), so the good patient-reported scores cannot be attributed to surgery versus natural recovery. With n=11 from a single surgeon, the study is grossly underpowered for anything beyond descriptive hypothesis generation, and selection/referral bias is likely given the small, self-selected recreational cohort. The disconnect between high functional-scale scores and only one-third returning to preinjury sport level is the most clinically important signal here, but with this sample size it's a trend, not a finding.
Begränsningen
There's no control arm comparing surgical repair to nonoperative management or to a matched cohort, so it's impossible to know how much of the reported function is attributable to surgery itself versus injury severity and time.
Referensstudie
This sits within a small but growing Level IV/case-series literature on proximal hamstring tendon repair (using the Wood retraction classification referenced here), which has generally reported good pain relief and patient-reported function but inconsistent return to preinjury sport level, this study largely reinforces that pattern rather than resolving it, and larger comparative studies are still lacking.
Vad du gör på måndag
No change to Monday practice: this doesn't establish surgery as superior to conservative care, but it does support continuing to counsel active patients preoperatively that 'returning to sport' and 'returning to your prior level' are different endpoints, with roughly a two-thirds chance of not fully regaining preinjury level and a real risk of persistent numbness.
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