{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:45:47Z","timestamp":1777880747256,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Health Research Foundation of Central Denmark Region"},{"DOI":"10.13039\/501100007438","name":"familien hede nielsens fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007438","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgical treatment of patients with proximal hamstring avulsions provides good results; however, less is known about the outcome in patients who are offered conservative treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate the effect of surgical or conservative treatment (decided by a shared decision strategy) of proximal hamstring avulsions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 24 patients with magnetic resonance imaging\u2013verified proximal hamstring avulsion were included and had either surgical treatment (11 patients, 45% women; mean age, 50\u2009\u00b1\u200916\u2009years) or conservative treatment (13 patients, 46% women; mean age, 50\u2009\u00b1\u200917\u2009years). At baseline, 6\u2009months and 12\u2009months, all patients answered the Perth Hamstring Assessment Tool (PHAT) (0-100 scale) and Hip Sports Activity Scale (0-8 scale). Patients had their maximal hip extension strength and maximal strength at 30\u00b0 and 90\u00b0 of knee flexion measured in newton meters per kilogram using a handheld dynamometer. A minimal important change in PHAT was considered &gt;7 points and a minimal important change in strength was considered &gt;0.15\u2009N\u00b7m\/kg, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The surgical group had a shorter time from injury to initiation of treatment compared with the conservative group (median: 15 vs 64 days; P = .02). The surgical group had a greater amount of retraction of the tendons compared with the conservative group (3 vs 2 cm; P = .04). From baseline to 12-month follow-up, the surgical and conservative groups improved their mean PHAT scores (35 points [95 CI, 24-45 points] and 20 points [95% CI, 9-31 points], respectively) reaching a median of 79 points (interquartile range [IQR], 66-95 points) in the surgical group and 75 points (IQR, 66-85 points) in the conservative group at the 12-month follow-up. Their Hip Sports Activity Scale levels at 12 months were 3 points (95% CI, 1-4 points) and 1 point (95% CI, 0-3 points) (not significant). Furthermore, the surgical and conservative groups improved their maximal hip extension strength by 0.61 N\u00b7m\/kg (IQR, 0.42-0.80 N\u00b7m\/kg) and 0.62 N\u00b7m\/kg (IQR, 0.13-1.10 N\u00b7m\/kg), respectively. Their maximal knee flexion strength at 30\u00b0 improved by 0.52 N\u00b7m\/kg (IQR, 0.29-0.74 N\u00b7m\/kg) and 0.32 N\u00b7m\/kg (IQR, 0.12-0.52 N\u00b7m\/kg) and their maximal knee flexion strength at 90\u00b0 improved by 0.28 N\u00b7m\/kg (IQR, 0.19-0.37 N\u00b7m\/kg) and 0.22 N\u00b7m\/kg (IQR, 0.02-0.41 N\u00b7m\/kg). At the 12-month follow-up, the side-to-side difference in maximal muscle strength was 6% and 7%, respectively, during hip extension and 19% to 25% and 16% to 17%, respectively, during knee flexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Twelve months after treatment of proximal hamstring avulsion, good clinical outcomes were seen when using a shared decision strategy regardless of whether the strategy led to surgical or conservative treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671241275656","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T06:25:17Z","timestamp":1729491917000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Proximal Hamstring Avulsions: Surgical Versus Conservative Treatment Using a Shared Decision-Making Strategy"],"prefix":"10.1177","volume":"12","author":[{"given":"Kasper","family":"Spoorendonk","sequence":"first","affiliation":[{"name":"H-Hip, Department of Physio and Occupational Therapy and Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Bagger","family":"Bohn","sequence":"additional","affiliation":[{"name":"H-Hip, Department of Physio and Occupational Therapy and Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens Ole","family":"Storm","sequence":"additional","affiliation":[{"name":"H-Hip, Department of Physio and Occupational Therapy and Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bent","family":"Lund","sequence":"additional","affiliation":[{"name":"H-Hip, Department of Physio and Occupational Therapy and Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0802-9660","authenticated-orcid":false,"given":"Signe","family":"Kierkegaard-Br\u00f8chner","sequence":"additional","affiliation":[{"name":"H-Hip, Department of Physio and Occupational Therapy and Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"bibr1-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2019-000420"},{"key":"bibr2-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211043097"},{"key":"bibr3-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4214-y"},{"key":"bibr4-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517732526"},{"key":"bibr5-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-015-9260-4"},{"key":"bibr6-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1273753"},{"key":"bibr7-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05717-7"},{"key":"bibr8-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102615"},{"key":"bibr9-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2022.2059560"},{"key":"bibr10-23259671241275656","doi-asserted-by":"publisher","DOI":"10.26603\/001c.37907"},{"key":"bibr11-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-2912-x"},{"key":"bibr12-23259671241275656","doi-asserted-by":"publisher","DOI":"10.5301\/hipint.5000006"},{"key":"bibr13-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211008568"},{"key":"bibr14-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-03582-2"},{"key":"bibr15-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514528788"},{"key":"bibr16-23259671241275656","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20081101-26"},{"key":"bibr17-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117738551"},{"key":"bibr18-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518786971"},{"key":"bibr19-23259671241275656","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2009.00958.x"},{"key":"bibr20-23259671241275656","unstructured":"UW Health Sports Medicine. 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