Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration

Abstract

We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting.

Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

“…Many different open or minimally invasive surgical procedures have been proposed, including open or endoscopic curettage of the symphysis pubis, arthrodesis of the symphysis with or without bone graft and wedge resection 38. All procedures can be associated with the release of the adductor tendons or with adductor enthesis repair 2,39–41. These surgical treatments vary widely in their invasiveness, impact on pelvic biomechanics and recovery time.…”

Core Muscle Injury Producing Groin Pain in the Athlete: Diagnosis and Treatment

“…Multiple techniques for addressing the current concept of CMI, with focus on the rectus abdominis and adductor longus, have been described including endoscopic and mini-open techniques. 10,15,18 Mini-open techniques are done through a few centimeters long incision over the anterior pelvis. The goal of the procedure is to repair the rectus abdominis as needed and lengthen the adductor longus tendon through either fractional lengthening or tenotomy.…”

Endoscopic hip osteotomies: less invasive approaches to peri-acetabular, proximal femoral and pubic symphyseal procedures

“…The completed resection gap is approximately 8–10 mm along the entire pubic symphysis. Associated adductor longus tendinopathy [ 27 ] or tears and even a torn rectus abdominus attachment may be treated via this approach. The indwelling bladder catheter is removed following routine portal closure.…”