{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:55:40Z","timestamp":1791219340317,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Proximal hamstring tendon avulsions are being treated surgically at rising rates, and although primary repair reliably restores function and return to sport in the acute setting, chronic and significantly retracted tears present a far more difficult problem. When direct repair is not feasible for a chronic, retracted proximal hamstring tendon avulsion, allograft reconstruction offers a bridge across a gap that would otherwise go unaddressed. However, significant chronicity and retraction are difficult challenges to overcome, and patient expectations must be appropriately counseled. As a salvage procedure, allograft reconstruction may improve patient outcomes significantly; however, it is not expected to restore full function, return athletic individuals to their baseline and preinjury level of sports participation, or match the success of primary repair. Allograft reconstruction may also carry more than double the risk of rerupture, which is important to discuss with patients up front. Graft choice and postoperative rehabilitation protocols remain heterogeneous across the limited available literature, and a validated tool to risk\u2010stratify which chronic, retracted tears are best served by reconstruction versus continued nonoperative management does not yet exist. These findings suggest that allograft reconstruction is a viable and clinically meaningful option for a difficult, often nonoperatively unsalvageable problem, but surgeons should frame it for patients as a salvage procedure rather than a full restoration of function, and expectations should be set accordingly.<\/jats:p>","DOI":"10.1002\/arj.70671","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:05:06Z","timestamp":1791216306000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Editorial Commentary<\/i>\n                    : Allograft Reconstruction in Chronic Proximal Hamstring Tendon Avulsions: Bridging the Gap May Not Equal a Full Return"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6006-5397","authenticated-orcid":false,"given":"Joshua P.","family":"Castle","sequence":"first","affiliation":[{"name":"Beth Israel Deaconess Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5924-7639","authenticated-orcid":false,"given":"Lafi S.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Henry Ford Health  Clinton Twp Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"crossref","first-page":"336","DOI":"10.2340\/17453674.2023.13650","article-title":"Increasing incidence of surgically treated hamstring injuries: A nationwide registry study in Sweden between 2001 and 2020","volume":"94","author":"Laszlo S","year":"2023","journal-title":"Acta Orthop"},{"key":"e_1_2_3_3_1","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1177\/03635465231164931","article-title":"Hamstring injuries: A current concepts review: Evaluation, nonoperative treatment, and surgical decision making","volume":"52","author":"Allahabadi S","year":"2024","journal-title":"Am J Sports Med"},{"key":"e_1_2_3_4_1","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1177\/0363546514555327","article-title":"Outcome after surgical repair of proximal hamstring avulsions: A systematic review","volume":"43","author":"van der Made AD","year":"2015","journal-title":"Am J Sports Med"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.70490"},{"key":"e_1_2_3_6_1","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1177\/03635465251338078","article-title":"Long\u2010term outcomes of partial proximal hamstring avulsion repair: Mean 10\u2010year follow\u2010up","volume":"53","author":"Rothrauff BB","year":"2025","journal-title":"Am J Sports Med"},{"key":"e_1_2_3_7_1","doi-asserted-by":"crossref","DOI":"10.1002\/arj.70513","article-title":"Structural allograft reconstruction for chronic proximal hamstring avulsion yields significant functional improvement, acceptable satisfaction, but limited return to preinjury sport levels","author":"Lef\u00e8vre N","year":"2026","journal-title":"Arthroscopy"},{"key":"e_1_2_3_8_1","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1177\/03635465241233734","article-title":"Risk factors for rerupture after proximal hamstring avulsion injury including the optimal timing for surgery","volume":"52","author":"Lef\u00e8vre N","year":"2024","journal-title":"Am J Sports Med"},{"key":"e_1_2_3_9_1","doi-asserted-by":"crossref","first-page":"e1133","DOI":"10.1016\/j.eats.2020.04.011","article-title":"Endoscopic\u2010assisted anatomic reconstruction of chronic proximal hamstring avulsion with Achilles allograft","volume":"9","author":"Leininger A","year":"2020","journal-title":"Arthrosc Tech"},{"key":"e_1_2_3_10_1","doi-asserted-by":"crossref","first-page":"103773","DOI":"10.1016\/j.eats.2025.103773","article-title":"Reconstruction of chronic proximal hamstring avulsion injury using quadriceps allograft: A technical note","volume":"14","author":"Lefevre N","year":"2025","journal-title":"Arthrosc Tech"},{"key":"e_1_2_3_11_1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1302\/2046-3758.153.BJR-2025-0231.R1","article-title":"Proximal hamstring reconstruction with a semitendinosus tendon allograft exhibits superior time\u2010zero biomechanical properties compared to reconstruction with an Achilles tendon allograft","volume":"15","author":"Nishimura H","year":"2026","journal-title":"Bone Joint Res"},{"key":"e_1_2_3_12_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00167-008-0588-9","article-title":"Allograft reconstruction for symptomatic chronic complete proximal hamstring tendon avulsion","volume":"17","author":"Marx RG","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_3_13_1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1177\/0363546507312167","article-title":"Surgical treatment of acute versus chronic complete 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