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More prospective and good quality studies are needed to compare surgical techniques and time to return to sports. Avulsions with retraction of more than 20mm and high demand patients may benefit from surgical treatment. Patients should be counselled accordingly. Both conservative and operative treatment provide excellent outcomes in proximal rectus femoris avulsions, with similar rates of return to sports and incidence of complications. More prospective and good quality studies are needed to compare surgical techniques and time to return
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