Laparoscopic hernia repair with adductor tenotomy for athletic pubalgia: an established procedure for an obscure entity

Rossidis, Georgios; Perry, Andrew; Abbas, Husain; Motamarry, Isaac; Lux, Tamara; Farmer, Kevin C.; Moser, Michael W.; Clugston, James R.; Caban, Angel M.; Ben-David, Kfır

doi:10.1007/s00464-014-3679-3

Cited by 34 publications

(25 citation statements)

References 23 publications

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“… 22 Fifty-four athletes treated by laparoscopic extraperitoneal inguinal hernia repair with synthetic mesh combined with ipsilateral adductor longus tenotomy returned to full sports-related activity in 24 days (range, 21-28 days). 70 …”

Section: Treatment Of Athletic Pubalgiamentioning

confidence: 99%

Groin Injuries (Athletic Pubalgia) and Return to Play

et al. 2016

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Context:Groin pain is a common entity in athletes involved in sports that require acute cutting, pivoting, or kicking such as soccer and ice hockey. Athletic pubalgia is increasingly recognized as a common cause of chronic groin and adductor pain in athletes. It is considered an overuse injury predisposing to disruption of the rectus tendon insertion to the pubis and weakness of the posterior inguinal wall without a clinically detectable hernia. These patients often require surgical therapy after failure of nonoperative measures. A variety of surgical options have been used, and most patients improve and return to high-level competition.Evidence Acquisition:PubMed databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms groin pain, sports hernia, athletic pubalgia, adductor strain, osteitis pubis, stress fractures, femoroacetabular impingement, and labral tears.Study Design:Clinical review.Level of Evidence:Level 4.Results and Conclusion:Athletic pubalgia is an overuse injury involving a weakness in the rectus abdominis insertion or posterior inguinal wall of the lower abdomen caused by acute or repetitive injury of the structure. A variety of surgical options have been reported with successful outcomes, with high rates of return to the sport in the majority of cases.

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Section: Treatment Of Athletic Pubalgiamentioning

confidence: 99%

Groin Injuries (Athletic Pubalgia) and Return to Play

et al. 2016

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Clelland

2018

Surg Radiol Anat

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PurposeGroin injury, sportsman’s groin and inguinal disruption (ID) refer to a diffuse chronic groin pain syndrome that has significant impact on athletes and is often unresponsive to conservative management. The ID aetiology is poorly understood but may involve weakness of the inguinal ligament attachments or the posterior inguinal canal wall or the tendons of adductor longus and rectus abdominis. We discuss the literature in which the inguinal ligament was directly targeted for ID management in athletic populations. Secondarily, we discuss the anatomical reclassification of the inguinal ligament to a tendon based on the above information.MethodsThis was a qualitative review of the published literature, in English, from January 2007 to February 2017.ResultsFive research papers, including 264 patients, were appraised. In patients with ID, tears were identified in the inguinal ligament, and to relieve pain, the surgical treatment of the ligament by tenotomy was shown to be beneficial. Techniques such as radiofrequency denervation involving the inguinal ligament and ilioinguinal nerve were also shown to relieve symptoms in athletes.ConclusionsThis qualitative review has specifically focused on the literature directly targeting the inguinal ligament in ID which is a relatively unexplored management approach. When treated as a tendon, the inguinal ligament appears to be an appropriate ID therapeutic target. Integrated studies and randomised clinical trials will promote a better understanding of the role of the inguinal ligament and its tendinous properties in ID and provide a foundation for evidence-based management of chronic groin pain in athletes.

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“…A retrospective study by Rossidis et al investigated 54 patients with CMI/AP symptoms who underwent combined laparoscopic TEP inguinal hernia repair and ipsilateral adductor longus tenotomy. All were able to return to full sports activity in a mean of 24 days (range 21–28 days) ( 14 ).…”

Section: Managementmentioning

confidence: 99%

The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

2016

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Chronic groin pain in athletes represents a major diagnostic and therapeutic challenge in sports medicine. Two recognized causes of inguinal pain in the young adult athlete are core muscle injury/athletic pubalgia (CMI/AP) and femoroacetabular impingement (FAI). CMI/AP and FAI were previously considered to be two distinct entities; however, recent studies have suggested both entities to frequently coincide in the athlete with groin pain. This article briefly discusses the role of FAI in CMI/AP and the diagnosis and management of this complex disease.

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Laparoscopic hernia repair with adductor tenotomy for athletic pubalgia: an established procedure for an obscure entity

Cited by 34 publications

References 23 publications

Groin Injuries (Athletic Pubalgia) and Return to Play

Groin Injuries (Athletic Pubalgia) and Return to Play

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

The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

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