Adductor Tenotomy as a Treatment for Groin Pain in Professional Soccer Players

Abstract

Chronic, exercise-related groin pain is a debilitating condition. Nonoperative treatment has limited efficacy, but surgical intervention on the adductor-abdomino complex may be used to alleviate symptoms and allow return to play (RTP). The purpose of this study was to report the outcome of adductor tenotomy and hernioplasty for professional soccer players with groin pain. Between 2000 and 2006, a total of 155 professional and recreational soccer players with recalcitrant groin pain (with or without lower abdominal pain) and resistance to conservative treatment were included in this retrospective analysis. Ninety-six patients were treated with adductor tenotomy and 59 patients were treated with combined adductor tenotomy and hernioplasty. No difference in pre- or postoperative parameters was detected between groups, apart from abdominal wall muscle defects revealed during ultrasound for patients in the combined group. The RTP time and subjective and objective outcome measures were compared. A combined score was developed to evaluate outcomes that consisted of overall satisfaction (50%), RTP time (15%), and Tegner scores (35%). Mean RTP was 11 weeks (range, 4-36 weeks). Postoperative Tegner score remained 8.2 (same as the preinjury Tegner score). Subjective outcome was rated 4.3 of 5. The combined score indicated 80% of good or excellent results for both groups. Surgical intervention allows RTP at the same level in professional soccer players following failure of nonoperative treatments. Athletes with adductor syndrome and accompanying sportsman's hernia may benefit from adductor tenotomy alone.

The use of platelet-rich plasma to augment conservative and surgical treatment of hip and pelvic disorders

“…Adductor tendinopathy typically presents with groin pain and is often seen in soccer players due to the frequency of running and cutting movements involved in this sport. 37 Athletic pubalgia is a more general term involving groin pain, often in athletes, with adductor tendinopathy being a frequent concomitant pathology in these patients. Good outcomes have been shown following adductor tenotomy with and without hernioplasty 37 , though PRP provides a non-operative treatment option for this pathology.…”

Sonographic Prevalence of Groin Hernias and Adductor Tendinopathy in Patients With Femoroacetabular Impingement

“…The cause is yet rather unknown, also reflected by different treatment recommendations ranging from nonoperative measures to surgical adductor release. 11,27,37,40 In the present FAI cohort, adductor insertion tendinopathy was evident in more than 20% of the cases. The clinical relevance of concomitant adductor tendinopathy is, however, unclear.…”

A qualitative literature review exploring the role of the inguinal ligament in the context of inguinal disruption management

“…The latter is considered an appropriate target as it has been pathologically implicated in groin injuries [9, 21, 26]. Interventional strategies, such as nerve blockade or surgery, may be considered after 2–3 months of unsuccessful conservative management.…”

“…Although there is literature relating to the treatment of ID in elite sportspeople, particularly utilising mesh repair procedures and adductor longus tenotomy [9, 21, 26], direct targeting of the inguinal ligament for therapeutic purposes is a relatively new and unexplored innovation and this review provides novel insights into this topic.…”