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However, there is sometimes a role for non-operative management of full-thickness ruptures in patients who are not highly active or in those who are poor candidates for surgery

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25 Castelli MC, Friedman K, Sherry J et al (2011) Comparing the efficacy and tolerability of a new daily oral vitamin B12 formulation and intermittent intramuscular vitamin B12 in normalizing low cobalamin levels: a randomized, open-label, parallel-group study

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Studies have found concerning contamination rates including incorrect amino acid sequences in 30% of tested products and endotoxin levels exceeding safe thresholds in 65% of samples