Central Tendon Injuries of Hamstring Muscles: Case Series of Operative Treatment.

Lempainen L1, Kosola J1, Pruna R2, Puigdellivol J2, Sarimo J1, Niemi P1, Orava S1.

Author information

1 Sports Trauma Research Unit, Hospital Mehiläinen NEO, Turku, Finland.
2 FC Barcelona, Medical Services, FIFA Center of Excellence, Barcelona, Spain.



As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings.


To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes.

Study Design:

Case series; Level of evidence, 4.


Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment. The indication for surgery was recurrent (n = 6) or acute (n = 2) central hamstring tendon injury. All patients followed the same postoperative rehabilitation protocol, and return to play was monitored.


Magnetic resonance imaging found a central tendon injury in all 3 hamstring muscles (long head of the biceps femoris, semimembranosus, and semitendinosus) with disrupted tendon ends. In acute and recurrent central tendon injuries, full return to play was achieved at 2.5 to 4 months. There were no adverse events during follow-up.


Central tendon injuries of the hamstrings can be successfully repaired surgically after acute and recurrent ruptures.


MRI; central tendon rupture; hamstring; return to play; surgical treatmentPMID: 29479545 PMCID: PMC5818092 DOI: 10.1177/2325967118755992

Read article: Lempainen et al OJSM 2018 Central Tendon Rupture Hamstring (pdf)


Lasse Lempainen
orthopaedic surgeon
adjunct professor

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Lasse Lempainen

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