{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:30:57Z","timestamp":1773405057361,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Amsterdam UMC"},{"DOI":"10.13039\/501100001827","name":"Universiteit van Amsterdam","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001827","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare outcome of operative and non\u2010operative treatment of avulsion fractures of the hamstring origin, with minor (&lt;\u20091.5\u00a0cm) and major (\u2265\u20091.5\u00a0cm) displacement, and early (\u2264\u20094 weeks) and delayed (&gt;\u20094 weeks) surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature search was performed using PubMed, Cochrane, Embase, CINAHL and SPORTDiscus. A quality assessment was performed using the Physiotherapy Evidence Database (PEDro) scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies with 90 patients (mean age: 16 years) were included. All studies had low methodological quality (PEDro score\u2009\u2264\u20095). Operative treatment yielded a return to preinjury activity rate (RTPA) of 87% (95% CI: 68\u201395), return to sports (RTS) rate of 100% (95% CI: 82\u2013100), Harris hip score (HHS) of 99 (range 96\u2013100) and a University of California Los Angeles activity scale (UCLA) score of 100%. Non\u2010operative treatment yielded a RTPA rate of 100% (95% CI:68\u2013100), RTS rate of 86% (95% CI: 69\u201394), HHS score of 99 (range 96\u2013100), and non\u2010union rate of 18% (95% CI: 9\u201334). All patients with minor displacement were treated non\u2010operatively (RTPA: 100% [95% CI: 21\u2013100], RTS: 100% [95% CI: 51\u2013100]). For major displacement, operative treatment led to RTPA and RTS rates of 86% (95% CI: 65\u201395) and 100% (95% CI: 84\u2013100), and 0% (0\/1, 95% CI: 0\u201379) and 100% (95% CI: 51\u2013100) for non\u2010operative treatment. Early surgery yielded RTPA and RTS rates of 100% (95% CI: 34\u2013100 &amp; 57\u2013100) compared to 100 (95% CI: 72\u2013100) and 90% (95% CI: 60\u201398) for delayed repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>All included studies have high risk of bias. There is only low level of evidence with a limited number of included patients to compare outcome of operative and non\u2010operative treatment. Overall outcome was satisfactory. There is a treatment selection phenomenon based on displacement, with acceptable outcome in both groups. There is insufficient data to draw conclusions regarding timing of surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06222-y","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T02:03:00Z","timestamp":1597716180000},"page":"1813-1821","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Satisfactory clinical outcome of operative and non\u2010operative treatment of avulsion fracture of the hamstring origin with treatment selection based on extent of displacement: a systematic review"],"prefix":"10.1002","volume":"29","author":[{"given":"Hijleke J. A.","family":"Nauta","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Amsterdam UMC University of Amsterdam, Amsterdam Movement Sciences Meibergdreef 9 1105AZ Amsterdam the Netherlands"},{"name":"<!--<label>2<\/label>--> Academic Center for Evidence\u2010Based Sports Medicine (ACES) Amsterdam UMC Amsterdam the Netherlands"},{"name":"<!--<label>3<\/label>--> Amsterdam Collaboration for Health and Safety in Sports (ACHSS) AMC\/VUmc IOC Research Center Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-6439","authenticated-orcid":false,"given":"Anne D.","family":"van der Made","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Amsterdam UMC University of Amsterdam, Amsterdam Movement Sciences Meibergdreef 9 1105AZ Amsterdam the Netherlands"},{"name":"<!--<label>2<\/label>--> Academic Center for Evidence\u2010Based Sports Medicine (ACES) Amsterdam UMC Amsterdam the Netherlands"},{"name":"<!--<label>3<\/label>--> Amsterdam Collaboration for Health and Safety in Sports (ACHSS) AMC\/VUmc IOC Research Center Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes L.","family":"Tol","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Amsterdam UMC University of Amsterdam, Amsterdam Movement Sciences Meibergdreef 9 1105AZ Amsterdam the Netherlands"},{"name":"<!--<label>2<\/label>--> Academic Center for Evidence\u2010Based Sports Medicine (ACES) Amsterdam UMC Amsterdam the Netherlands"},{"name":"<!--<label>3<\/label>--> Amsterdam Collaboration for Health and Safety in Sports (ACHSS) AMC\/VUmc IOC Research Center Amsterdam the Netherlands"},{"name":"<!--<label>4<\/label>--> Aspetar, Orthopaedic and Sports Medicine Hospital Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustaaf","family":"Reurink","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Amsterdam UMC University of Amsterdam, Amsterdam Movement Sciences Meibergdreef 9 1105AZ Amsterdam the Netherlands"},{"name":"<!--<label>2<\/label>--> Academic Center for Evidence\u2010Based Sports Medicine (ACES) Amsterdam UMC Amsterdam the Netherlands"},{"name":"<!--<label>3<\/label>--> Amsterdam Collaboration for Health and Safety in Sports (ACHSS) AMC\/VUmc IOC Research Center Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gino M.","family":"Kerkhoffs","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Amsterdam UMC University of Amsterdam, Amsterdam Movement Sciences Meibergdreef 9 1105AZ Amsterdam the Netherlands"},{"name":"<!--<label>2<\/label>--> Academic Center for Evidence\u2010Based Sports Medicine (ACES) Amsterdam UMC Amsterdam the Netherlands"},{"name":"<!--<label>3<\/label>--> Amsterdam Collaboration for Health and Safety in Sports (ACHSS) AMC\/VUmc IOC Research Center Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0031\u20103955(02)00010\u2010X"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000088"},{"key":"e_1_2_10_4_2","first-page":"470","article-title":"Apophyseal avulsion fractures of the pelvis. 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