Posterior Thigh (Hamstrings) Excision

It is a procedure that involves removing a tumor (usually malignant or benign aggressive) of the posterior thigh (hamstring muscles) while preserving the surrounding bone and soft tissues.

Hamstrings Mri2

What is a Hamstring Muscles Resection?

The posterior compartment of the thigh (hamstrings) is the least common site of the three compartments of the thigh (anterior, posterior, medial) for soft tissue tumors to arise. Approximately 15% to 20% of soft tissue sarcomas around the thigh arise in the posterior hamstring compartment. The major muscles of the posterior thigh (hamstring muscles) include the biceps femoris, semimembranosus, and semitendinosus muscles. Although resection of the muscular elements of this compartment does not considerably affect overall function of the lower extremity, the proximity of the major nerves, arteries, and veins of the lower extremity to this area requires special attention in the preoperative evaluation process and during tumor removal. Some of the most common types of soft tissue tumors that arise in this site include lipomas and low-grade liposarcomas. High-grade soft tissue sarcomas may adhere to some of the vascular structures (veins and arteries) and require careful dissection and preservation of the femoral (femur) vessels. About 90% of soft tissue sarcomas arising in the anterior thigh (quadriceps muscles) can be resected and treated adequately by a limb-sparing surgery. In some instances the extremity cannot be saved and an amputation is performed. 

Contraindications for saving the limb may include neurovascular invasion, infection, pathological fracture, invasion of the pelvic floor, extensive disease, contamination from a poorly performed biopsy, recurrent disease.

Hamstrings Dissection



What’s involved in the technique?

What you can expect afterwards

After your surgery you will spend a few nights in the hospital and then will be recuperating at home. Various pain protocols and nerve blocks are used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. You will return to the office 2 weeks after surgery. Once cleared, you will subsequently start physical therapy. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.  

You will be monitored periodically with MRI imaging over the course of 5 years to ensure there are no signs of recurrence. You will have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year. Since the integrity of the limb has been restored to full or almost full, recovery is anticipated provided the patient adheres to strict physical therapy. 

Types Of Physical Therapy

Posterior Thigh (Hamstrings) Muscle Excision Video

Dr. James Wittig narrates a video illustrating the surgical technique for resection of a tumor of the posterior thigh (Hamstrings). | WATCH VIDEO