Introduction: Proximal hamstring tendon injuries are common among athletes and are often caused by movements involving rapid hip flexion while in knee extension. Treatment of these injuries includes tendon repair through operative intervention, but postoperative complications can occur, including deep vein thrombosis (DVT). The purpose of this study was to characterize the factors related to the development and treatment of DVTs following proximal hamstring repair.

Methods: A systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed and EMBASE were searched from database origin to May 2022. Studies were included if they discussed proximal hamstring repair, postoperative outcomes for at least 6 months, patient demographics, number of tendons injured, occurrence of DVT postoperatively, and specified acute or chronic injury.

Results: A total of 657 studies were identified, 8 of which (422 patients, 464 proximal hamstring repairs) met the inclusion criteria. Nine cases of DVT were identified in the postoperative period. 2 of the 9 (22.2%) DVTs occurred in patients undergoing repair for chronic proximal hamstring tendon ruptures. 33.3% (3/9) of the total DVTs were observed in patients with a complete proximal hamstring tear. 2 of the 9 (22.2%) occurred in patients with an acute, complete tear of the proximal hamstring tendon. One study (12.5%) reported the use of DVT prophylaxis, which yielded only 1/52 (0.02%) patients with postoperative DVT. Conclusions: There is limited data available regarding the incidence of DVT and postoperative prophylaxis protocols following repair of proximal hamstring avulsion injuries. The results of this study demonstrated that more than half of (5/9) DVTs occurred in patients with a complete proximal hamstring tendon avulsion. Although all patients undergoing repair of proximal hamstring avulsion injuries are at risk of developing a DVT, there is currently no standard prophylactic regimen. Orthopaedic surgeons should strongly consider developing a method in attempt to decrease the incidence of postoperative DVTs.