Hamstring Tendon Transfer
A procedure to restore function by transferring a hamstring tendon to a damaged area
The hamstring tendons are vital for knee and hip movement, contributing to balance, stability, and power during activities such as walking, running, and jumping. In cases where tendons are damaged beyond repair or no longer functional, tendon transfer surgery may be recommended to restore movement and alleviate symptoms.
Common Reasons for Hamstring Tendon Transfer Surgery
- Significant tendon damage due to trauma, overuse, or degenerative conditions.
- Failed previous tendon repairs or chronic tendon dysfunction.
- Muscle imbalances or deformities affecting joint stability.
- Chronic pain or functional limitations in the affected limb.
The primary goals of hamstring tendon transfer are to restore strength, improve joint stability, and alleviate pain caused by tendon dysfunction.
Preparation for Surgery
Preparation for hamstring tendon transfer involves a thorough assessment by Dr Ben McGrath, including imaging studies such as X-rays, MRIs, or ultrasounds to determine the extent of the damage and plan the surgical approach.
Key Steps in Preparation:
- Consultation: Dr McGrath will explain the procedure, discuss potential benefits and risks, and answer any questions.
- Pre-Surgical Instructions: Patients may need to fast before surgery and adjust medications, such as stopping blood thinners.
- Prehabilitation: Strengthening exercises may help optimise recovery by improving the condition of surrounding muscles.
- Lifestyle Adjustments: Maintaining a healthy weight and ceasing smoking can enhance surgical outcomes and recovery.
What Happens During the Surgery?
Hamstring tendon transfer is typically performed under general anaesthesia and may involve minimally invasive or open surgical techniques, depending on the complexity of the condition.
Surgical Steps:
- Incisions: Small incisions are made to access the damaged tendon and surrounding structures.
- Harvesting the Tendon: A functional hamstring tendon, often from the same limb, is identified and carefully detached for transfer.
- Tendon Transfer: The harvested tendon is redirected to replace or augment the damaged tendon. It is then secured to its new location using sutures or fixation devices.
- Reinforcement: Additional sutures may be used to reinforce the repair and ensure stability.
- Closure: The incisions are closed with sutures or adhesive strips, and the area is bandaged for protection.
The procedure typically takes 2 to 3 hours, depending on the complexity of the case.
Understanding the Risks
While hamstring tendon transfer surgery is generally safe, it carries some potential risks:
- Infection: At the incision site or within the joint.
- Swelling and Stiffness: Temporary inflammation or reduced range of motion.
- Re-Rupture or Weakness: Rarely, the transferred tendon may not function as expected.
- Blood Clots: Rare but possible in the lower limbs.
- Nerve or Vessel Injury: Extremely rare but a potential complication during surgery.
Dr McGrath employs advanced surgical techniques and follows strict safety protocols to minimise these risks.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain Management: Mild to moderate discomfort can be managed with prescribed medications and regular icing.
- Immobilisation: A knee brace or splint may be used to protect the repair during initial recovery.
- Discharge Instructions: Patients will receive detailed guidance on wound care, activity restrictions, and follow-up appointments.
Rehabilitation and Recovery
Recovery from hamstring tendon transfer involves a structured rehabilitation program tailored to the patient’s needs:
Phase 1: Early Recovery (Weeks 0–6)
- Goals: Protect the transferred tendon, reduce swelling, and initiate gentle movement.
- Activities: Non-weight-bearing or partial weight-bearing with crutches, passive range-of-motion exercises, and cryotherapy.
Phase 2: Strength and Stability (Weeks 6–12)
- Goals: Restore range of motion and build strength in the affected area.
- Activities: Physiotherapy for strengthening surrounding muscles, light cycling, and balance exercises.
Phase 3: Advanced Recovery (Months 3–6)
- Goals: Improve functional strength and prepare for daily activities or sports.
- Activities: Progressive resistance training, functional drills, and light jogging.
Phase 4: Return to Activity (Months 6–12)
- Goals: Safely return to high-impact activities.
- Activities: Gradual reintroduction to sports and other physical activities under professional guidance.
Long-Term Outcomes
Hamstring tendon transfer surgery may help restore strength and mobility in the affected area, allowing patients to return to their desired activities with improved function. Long-term success depends on:
- Adherence to the rehabilitation program.
- Regular follow-up appointments to monitor progress.
- Maintaining a healthy lifestyle to support tendon and joint health.
Most patients experience significant improvements in mobility and strength, enabling them to regain confidence in their physical activities.