Reconstruction of Chronic Proximal Hamstring Avulsion Injury Using Quadriceps Allograft: A Technical Note

Chronic proximal hamstring ruptures are complex to manage as the result of tendon retraction, scarring, and potential sciatic nerve involvement. When primary repair is not feasible, graft reconstruction becomes necessary. This Technical Note describes a surgical technique using a fresh-frozen quadriceps tendon allograft to bridge chronic, irreparable proximal hamstring tears. The graft offers both sufficient length and biomechanical strength. The thick patellar end allows secure fixation to the ischial tuberosity with multiple anchors, while the fan-shaped distal portion is wrapped around the retracted tendon stump, minimizing the need for excessive knee flexion during fixation.