Purpose: The hamstrings are a group of long muscles that cross two joints, allowing for extension of the hip and flexion of the knee. They are used during powerful, ballistic impact motion, such as sprinting, which may subject the muscles to high force and considerable variations in length. Therefore, hamstring injuries most commonly occur during sports activity. Proximal hamstring tears or avulsions occur when the tendon tears off the pelvis and account for approximately 40% of all hamstring injuries. This video demonstrates the surgical technique for proximal hamstring repair and presents a case-based literature review of the outcomes of surgical and nonsurgical management of hamstring injuries.

Methods: This video discusses the case presentation of a 41-year-old woman who has been experiencing persistent left leg weakness and buttock pain for 3 weeks after injuring herself while water skiing. She sustained forceful flexion of her hip with her knees extended (the pike position), after which she experienced severe pain that limited her ability to ambulate for 2 days postinjury. In addition, she has been unable to return to her activities of daily living. The video reviews the radiographs, surgical indications, and preoperative planning for this patient. This patient elected to proceed with proximal hamstring tendon repair.

Results: After demonstrating the surgical technique, the video reviews postoperative rehabilitation protocol and patient follow-up. The patient returned to normal athletic activity without pain or discomfort 8 months postoperatively. A case-based literature review on the management of proximal hamstring injuries, including surgical and nonsurgical treatment and outcomes, is discussed.

Conclusions: Proximal hamstring tendon tears and avulsions may occur during various athletic activities. This video presents the surgical technique for and a case-based literature review of proximal hamstring tendon repair.