{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:06:38Z","timestamp":1779192398344,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to compare the patient\u2010reported outcome score, return\u2010to\u2010sports rate, knee flexion strength and complications of operative and non\u2010operative treatments for proximal hamstring tendon avulsions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of PubMed, Ovid and Scopus was conducted to identify clinical comparative studies with Levels 1\u20133 evidence on operative versus non\u2010operative management for proximal hamstring tendon avulsions. Studies were included if they reported post\u2010treatment clinical outcomes and met inclusion criteria: comparative design, English language, full\u2010text availability, and patient\u2010reported outcomes. Data were analyzed using odds ratios (ORs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, with heterogeneity assessed by chi\u2010square tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven studies, encompassing 8 cohorts and 592 cases (256 operative, 109 non\u2010operative), met the inclusion criteria. The Methodology Index for Non\u2010Randomized Studies scores for these studies ranged from 14 to 22, indicating a fair to good methodological quality. The operative group demonstrated a statistically significantly higher return\u2010to\u2010sport rate at pre\u2010injury performance levels compared to non\u2010operative management (65.2% vs. 50.7%; OR\u2009=\u20091.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Pooled meta\u2010analyses revealed no statistically significant differences in post\u2010treatment patient\u2010reported outcomes, as measured by the Lower Extremity Functional Scale (MD\u2009=\u20092.32; 95% CI: \u22120.41 to 5.05;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10) and the Perth Hamstring Assessment Tool (MD\u2009=\u20090.37; 95% CI: \u22123.61 to 4.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.86). Neurological complications, including sciatic nerve symptoms, were similar between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on fair to good\u2010quality studies, findings apply mainly to active, middle\u2010aged recreational athletes. The operative and non\u2010operative treatments yield similar patient\u2010reported outcomes in proximal hamstring avulsions, though operative management may facilitate a higher return\u2010to\u2010sport rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70327","type":"journal-article","created":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T10:26:27Z","timestamp":1752402387000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["No difference in patient\u2010reported outcomes between operative and non\u2010operative management of proximal hamstring injuries, but return to sports is higher in operative treatment: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7045-3222","authenticated-orcid":false,"given":"Napatpong","family":"Thamrongskulsiri","sequence":"first","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Sports Medicine Research Group, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5293-5428","authenticated-orcid":false,"given":"Danaithep","family":"Limskul","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Sports Medicine Research Group, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanathep","family":"Tanpowpong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Sports Medicine Research Group, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7256-4057","authenticated-orcid":false,"given":"Somsak","family":"Kuptniratsaikul","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-4871","authenticated-orcid":false,"given":"Anil S.","family":"Ranawat","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Hospital for Special Surgery New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8640-1651","authenticated-orcid":false,"given":"Thun","family":"Itthipanichpong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Sports Medicine Research Group, Faculty of Medicine Chulalongkorn University Bangkok 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