Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 18, Pages -Publisher
MDPI
DOI: 10.3390/jcm11185443
Keywords
proximal hamstring avulsion; allograft reconstruction; chronic; PRGF; platelet-rich plasma; PRP
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This article presents a novel surgical technique for the reconstruction of chronic proximal hamstring tear, addressing the challenges posed by tendon retraction and sciatic nerve entrapment. It involves using a semitendinosus tendon allograft and injecting plasma rich in growth factors to promote healing and protect the nerve.
The reconstruction of a chronic proximal hamstring tear is a challenging pathology that posits difficulties to surgeons due to the distal retraction of the hamstring tendon stumps and the entrapment of the sciatic nerve within the scar formed around the torn hamstring tendon. We describe a novel surgical technique using a semitendinosus tendon allograft sutured in a V inversion manner, thereby avoiding an excess of tension and length of the new reconstructed hamstring tendons. In addition, and in order to speed up the healing process and avoid new sciatic entrapment, we assisted the surgery with liquid plasma rich in growth factors (PRGF) injected intraosseously, intratendinously and within the suture areas, as well as wrapping the sciatic nerve with a PRGF membrane. In conclusion, this novel approach offers mechanical and biological advantages to tackle the large retraction of hamstring stumps and the entrapment of the sciatic nerve within the scar.
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