EP7.10 Side-to-side repair of proximal hamstring tendon injuries in athletes: facilitating rapid return to play and reducing recurrence risk

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ID: 331030
2026
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Abstract
Abstract Background Full-thickness proximal hamstring tendon injuries without avulsion, particularly involving the conjoint tendon or the long head of the biceps femoris, represent a challenging clinical entity in athletes. Conservative management is often favored due to a perceived faster return to play and avoidance of surgical risks; however, it has been associated with high recurrence rates, reported between 20% and 60% in sprinting athletes. Purpose To assess clinical outcomes, time to return to play, and the risk of recurrence following side-to-side surgical repair of proximal hamstring injuries in athletes. Methods A retrospective case series of ten elite athletes undergoing side-to-side proximal hamstring repair was performed. All patients presented with full-thickness tendon tears (BAMIC 4C) without avulsion. The mean age was 23.3 years (range 18–34); all were male, predominantly professional football players. Injuries involved the conjoint tendon (n=6) or the long head of the biceps femoris (n=4), with a mean tendon gap of 4.4 cm (range 3-8). The mean time to surgery was 10.8 days (range 4-19). The surgical technique aimed to restore tendon continuity and optimize the muscle–tendon length–tension relationship, return-to-play time, complications, and recurrence were assessed. Results All athletes returned to their pre-injury level of sport. The mean return-to-play time was 15.5 weeks (range 14–17 weeks), indicating a consistently rapid recovery for this injury type. No postoperative complications were observed, and no re-injuries or recurrences occurred during the follow-up period, which ranged from 12 to 25 months. Restoration of tendon continuity appeared to facilitate early functional progression without compromising tissue healing. Conclusion Side-to-side repair of proximal hamstring tendon tears in athletes may facilitate a predictable and fast return-to-play while effectively preventing recurrence. By restoring anatomical continuity and muscle-tendon tension, this technique offers a promising surgical strategy in high-demand athletes with structurally significant, non-avulsion injuries.
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Authors Wouter H. Peeters, Frans-Jozef Vandeputte, G Declercq
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.373
URL
https://doi.org/10.1093/jhps/hnag043.373
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