FP13.7 Early Repair Is Associated With Improved Outcomes After Proximal Hamstring Tendon Rupture

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ID: 330944
2026
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Abstract
Abstract ICLB13 - Outside the Joint: Mastering Extra-Articular Pain and Hip-Spine Basics, Session Room 6 (BMCC Level 3), October 9, 2026, 14:00 - 16:00 Objectives Early recognition and repair of proximal hamstring tendon ruptures is critical, as delays can increase tendon retraction, scarring, muscle atrophy, and tethering of the sciatic nerve, all of which can complicate surgical repair. Despite these concerns, the influence of surgical timing on patient outcomes remains unclear. Furthermore, practical barriers such as insurance referral delays may limit timely diagnosis and intervention. This study’s objective was to evaluate the effect of early versus delayed repair on clinical outcomes following primary proximal hamstring tendon repair. Methods A systematic review was performed in August 2024 according to PRISMA guidelines. Studies were included if they reported outcomes of primary proximal hamstring tendon repair, had ≥12 months of follow-up, and compared early versus delayed treatment. Early repair was defined as surgery within 4–6 weeks of injury. Primary outcomes included patient-reported outcomes (PROs), return to sport/activity, postoperative sciatica, re-tear, and revision. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for sciatica, re-tear, and revision using a random-effects model. Results Thirteen studies were included, encompassing 1,168 early and 795 delayed repairs. Mean patient age ranged from 29.7–53.8 years (early group) and 29.2–60.4 years (delayed group). Mean time to surgery was 1.6–3.6 weeks versus 16.9–89.6 weeks, with mean follow-up ranging from 12.0–58.8 months. Nine studies reported PROs at latest follow-up, of which three demonstrated significantly better scores in the early repair group, while the remainder found no difference. Return-to-sport/activity was reported in five studies but was heterogeneous: one study reported a higher rate of sports cessation following delayed repair, whereas others showed no difference in return-to-sport metrics. Pooled analysis demonstrated that early repair was associated with a significantly reduced risk of postoperative sciatica (RR 0.26, 95% CI 0.09–0.71, P<0.01) and re-tear (RR 0.57, 95% CI 0.36–0.88, P=0.01). Risk of revision surgery did not differ significantly between groups (RR 0.64, 95% CI 0.37–1.10, P=0.11). Conclusion Early surgical repair (within 4–6 weeks) of proximal hamstring tendon ruptures is associated with improved PROs, significantly lower risks of postoperative sciatica and re-tear, and comparable revision rates compared with delayed repair. These findings support early repair as the preferred strategy to optimize outcomes and reduce complications.
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Authors Muzammil Akhtar, Marlena Ramanis, Kory B. Dylan Pasko, Dean Wang
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.103
URL
https://doi.org/10.1093/jhps/hnag043.103
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