Retracted avulsion of the distal semimembranosus tendon: MRI evaluation and surgical repair

Hamstring injuries constitute up to 30% of lower-extremity pathology and are the leading cause of time lost from competition in elite athletes. Although hamstring injuries frequently involve the proximal or mid-substance regions, distal injuries are particularly uncommon and are therefore sparsely studied. Among these, biceps femoris tears predominate, whereas those of the semimembranosus and semitendinosus are less common. Distal hamstring injuries, particularly of the semimembranosus, are typically associated with concomitant meniscal, cruciate ligament, or collateral ligament injuries. We describe the rare presentation of a retracted avulsion of the distal insertion of the semimembranosus tendon, and the subsequent operative repair.