Table 1.

Advantages and Disadvantages of Allograft Augmentation Repair/Reconstruction of Chronic Proximal Hamstring Avulsion Injury

Advantages	Disadvantages
Repair even in chronic injuries leads to improved outcomes with increased strength and return to preinjury sports and recreational activities. Use of 5 suture anchors better reproduces native hamstring tendon strength. Use of a second Achilles allograft as an overwrap prevents excessive adhesions post operatively which may decrease incidence of sciatic nerve symptoms.	An extensile longitudinal approach is often needed for exposure and adequate mobilization of the retracted tendon stump. In chronic cases, adhesions and fibrous tissue make sciatic nerve neurolysis and mobilization of the retracted tendon stump more challenging. Significant tendon retraction >5 cm often precludes a direct repair and necessitates the use of allograft for reconstruction.