{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:14:02Z","timestamp":1773360842726,"version":"3.50.1"},"reference-count":66,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate patient\u2010reported outcomes, return to sport (RTS) rates and complications following proximal hamstring (PH) repair in elite and non\u2010elite athletes. We hypothesized that PH repair leads to improved patient\u2010reported and clinical outcomes and high RTS rates with relatively few associated complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In accordance with Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses guidelines, PubMed, Embase and Cochrane Library databases were searched in August 2024. Studies were included if they evaluated athletes at various levels of competition who underwent PH repair and reported RTS rates, complication rates or patient\u2010reported outcomes. Due to high heterogeneity between studies, qualitative comparative analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The initial screen identified 1398 studies; 22 were included. Each study had non\u2010comparative study design with low risk of bias. Overall, 168 patients across 6 studies were included in the elite athlete cohort, and 759 patients across 16 studies were included in the non\u2010elite athlete cohort. Elite athletes had overall RTS rate of 95.6% with time to RTS from 3.0 to 7.0 months, and RTS at pre\u2010injury level between 90.0% and 98.4%. RTS rate in non\u2010elite athletes was 64.8%. Mean lower extremity functional scale scores were 77.9\u201378.0 in elite athletes and 73.8\u201089.0 in non\u2010elite athletes. The overall complication rate in the elite athlete cohort was 11.6%, and in the non\u2010elite cohort was 14.2%. Nerve\u2010related symptoms were the most common complication in both cohorts, with rates of 2.9% and 10.9%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elite athletes are more likely to RTS following PH repair and do so faster compared to their non\u2010elite counterparts. Minor neurologic complications account for the majority of complications in both patient cohorts, with minimal incidence of operative failure or other complications. This can guide preoperative decision\u2010making and patient counselling based on a patient's athletic status and desire to RTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level IV, systematic review of Levels III and IV studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12759","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T13:13:44Z","timestamp":1752844424000},"page":"3389-3404","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Elite athletes return to sport faster and more often than non\u2010elite athletes with low complication rates following proximal hamstring repair: A systematic review"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9950-6938","authenticated-orcid":false,"given":"Udit","family":"Dave","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University 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