All-Endoscopic Modified Krackow Suture for Proximal Hamstring Repair

• Published in: Arthroscopy techniques (Amsterdam) Vol. 12; no. 8; pp. e1473 - e1478
• Main Authors: Brusalis, Christopher M., Fenn, Thomas W., Larson, Jordan H., Hapa, Onur, Nho, Shane J.
• Format: Journal Article
• Language: English
• Published: Elsevier 01.08.2023
• Subjects: Technical Note
• ISSN: 2212-6287; 2212-6287
• DOI: 10.1016/j.eats.2023.04.018

Surgical repair of proximal hamstring injuries can relieve pain and restore lower extremity function in active individuals. Whereas traditional surgical techniques are performed via an open approach, more recent endoscopic proximal hamstring repair techniques have proven safe, effective, and potentially associated with fewer complications than open repair. One theorized disadvantage of existing endoscopic techniques is reduced security at the suture-tendon interface, as compared to open surgery, during which a running suture technique, such as a Krackow stitch, may be employed. In this article, we present a technique for increasing suture purchase by performing an all-endoscopic, running, locking stitch during proximal hamstring repair. Video 1 Surgical technique video outlining the steps for an endoscopic proximally hamstring repair. Specifically, the video outlines a modified suture repair configuration, the modified Krackow, to replicate the biomechanical suture-tendon fixation of an open hamstring repair. This surgical video outlines portal placement, identification of relevant anatomy and pathology, anchor placement, suture passage, and final suture configuration.