The surgical literature has reported good to excellent outcomes in patients with chronic high (proximal) hamstring tendinopathy, who have failed to find relief with non-invasive or minimally invasive management.1,2 Surgical treatment can involve anything from debridement of the diseased tendon to complete tenotomy (cutting of the tendon) and reattachment.1
- Debridement involves the removal of diseased or damaged tissue, with the hopes that new, healthier tissue will grow in its place. The same technology used in tenotomy may allow this procedure to be performed in a minimally invasive fashion in certain patients.3-5 Interested patients should consult a qualified practitioner.
- Complete tenotomy, sometimes called a tendon release, involves cutting the tendon and reattaching it to the bone.1 If the sciatic nerve has become painfully trapped in scar tissue as a result of the tendinopathy, the surgeon may free it during this surgery (neurolysis). 6 Complete tenotomy surgery requires a long recovery period and should be reserved for patients who have exhausted other options.
Surgical treatment for chronic hamstring tendinopathy is elective surgery, meaning it is the patient’s choice. As always, it is important for doctors and patients to work together to individualize treatments based on the individual’s lifestyle, injury, and sport.