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Proximal hamstring avulsion often is seen in middle-aged recreational athletes due to inadequate stretching. Some orthopedists offer surgical management, despite a few case–control and cohort studies that have shown no superiority for surgery over nonoperative management. Scandinavian investigators conducted a study of 119 patients (mean age, 53) with proximal hamstring avulsions (documented by magnetic resonance imaging) who were randomized to operative or nonoperative management.
At 24 months, validated questionnaires on pain and function revealed nonoperative management to be noninferior to surgery in the per-protocol analysis (a 1-point difference on a 0–100-point scale). Biomechanical assessments also were similar for the two groups. Cr…