Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: A randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman’s hernia (athletic pubalgia)

Paajanen, Hannu; Brinck, Tuomas; Hermunen, Heikki; Airo, I

doi:10.1016/j.surg.2011.02.016

Cited by 132 publications

(132 citation statements)

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“…2,6,9,14,[22][23][24][25][26][27] Two articles focused on osteitis pubis confirmed on MRI or bone scan. 2,27 Eight studies 6,9,14,[22][23][24][25][26] investigated a total of 196 patients. From the 8 studies (Table 1), sixty-five percent were football players.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…6,9,14,23,24,26 The type of preoperative pain was not well described by any of the studies and was stated as being a dull ache or pulling sensation in 2 articles. 14,25 Pain was reported to occur at rest in 81% of patients 6,14,22,24 and had lasted between 2 and 13 months. 6,9,14,22,[24][25][26] Most studies reported an initial conservative approach incorporating measures such as rest, steroids, physiotherapy, hydrotherapy, and analgesics.…”

Section: Resultsmentioning

confidence: 99%

“…However there are variable results, and athletes often return for more definitive solutions such as surgical intervention. [12][13][14] Operative measures are reported by some as having good results, with 90% to 96% of patients returning to sport activity after open repair with or without mesh. 15,16 Evidence over the previous 2 decades has suggested that laparoscopic procedures have considerable advantages over open techniques in other settings, 17,18 and this has been extended to totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) techniques.…”

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confidence: 99%

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A Literature Review on the Role of Totally Extraperitoneal Repairs for Groin Pain in Athletes

Siddiqui

Kovzel

Brennan

et al. 2013

International Surgery

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A literature review was made on the role of totally extraperitoneal (TEP) hernia repairs for groin pain in athletes. Electronic databases were searched for literature published from January 1993 to November 2011. There were 10 articles incorporating 196 patients included in this review. Thirty percent of patients were reported to have direct inguinal hernias, 22% had indirect inguinal hernias, and 41% had dilated internal rings. Of note, 30% of cases had no macroscopic abnormality. Four studies reported on an early followup ranging between 3 and 6 weeks. Only minimal or mild symptoms were reported. Up to 33% of patients had impaired ability to perform at peak levels. Up to 53% of patients had persistence of symptoms at the early follow-up. Total follow-up time ranged from 3 to 80 months, and most patients were active (90%-100%). At long-term follow-up, 3% to 10% were unable to play, and 5% were reported as being unable to train. Two studies from the same center reported on TEP surgery for osteitis pubis, and most patients returned to sporting activity after 4 to 8 weeks. TEP repair is a good operative intervention in athletes with chronic groin pain not relieved by conservative measures. Athletes recover quickly and return to sport early.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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A Literature Review on the Role of Totally Extraperitoneal Repairs for Groin Pain in Athletes

Siddiqui

Kovzel

Brennan

et al. 2013

International Surgery

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“…Alternatively, a laparoscopic repair as described by Paajanen et al [7] or Edelman and Selesnick [8] involves mesh placed behind the inguinal floor in the pre-peritoneal space. Mesh is commonly used in the laparoscopic repair of inguinal hernias and sports hernias.…”

Section: Discussionmentioning

confidence: 99%

Hybrid mesh for sports hernia repair

Edelman¹

2017

MIS

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Aim:Mesh is commonly utilized in the laparoscopic repair of sports hernias. A hybrid mesh was recently released containing a single light weight layer of macroporous, polypropylene mesh between layers of biologic mesh. Having an extensive experience with laparoscopic and sports hernia repairs, a small sample of hybrid mesh was trialed. Methods: From April 2015 to August 2016, 16 male patients with sports hernias were consented for hybrid mesh repair. A prospective data base was developed and patients were followed at 1 week, 4 weeks and 4 months after surgery. Results: Ages ranged from 18 years to 43 years (average 22.9 years). Operative times ranged from 25 min to 75 min (average 42.5 min). All were athletes playing basketball, soccer, baseball, football and track. There were no operative problems. Two patients developed post-operative seromas requiring radiologic drainage. All patients completed a postoperative therapy program and all have returned to their sport without problems. Conclusion: There is not one type of mesh repair that has been proven to be the most effective treatment for sports hernias. Continued follow up as well as a more structured study will be necessary to prove if hybrid mesh has long term effectiveness for the laparoscopic treatment of sports hernias. The initial study has promising findings. Key words:Sports hernia, osteitis pubis, laparoscopic hernia repair, inguinal hernia, biologic mesh, hybrid biologic mesh ABSTRACTArticle history:

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Groin Pain Syndrome Known as Sports Hernia

2020

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he incidence of groin pain among athletes is estimated to be from 2% to 20%; however, the incidence in the general population is unknown. Groin hernias and hip joint pathologic findings are common and often considered; once ruled out by physical examination with or without imaging, the differential diagnoses and workup of groin pain is confounding to many practitioners. This ambiguous nature of nonhernia, nonhip groin pain is understandable because routine physical examination often only reveals groin tenderness, and imaging may or may not have abnormalities. Most of the literature written about the subject are case series or opinions. Many of these case series only involve professional male athletes, and the reported end points are often: return to sport, time to return to sport, or level of sport. Thus, the level of evidence of the studies is low quality, and the findings may not be applicable to the general population. In the past 2 decades, treating practitioners have attempted to better classify and describe the common pattern of symptoms, examination and imaging findings, and noted anatomic abnormalities at the time of operative management. Common lexicon is necessary so that meaningful comparisons can be made. 1 The literature search for this narrative review is highlighted in the eFigure in the Supplement.Various nomenclature has been used for nonhernia, nonhip groin pain including athletic pubalgia, sports hernia, core muscle injury, Gilmore groin, sportsman groin, inguinal disruption, and several others. [2][3][4][5] Inclusion of the word hernia in the jargon is misrepresentative. We prefer the broad but descriptive term groin pain syndrome.

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Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: A randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman’s hernia (athletic pubalgia)

Cited by 132 publications

References 24 publications

A Literature Review on the Role of Totally Extraperitoneal Repairs for Groin Pain in Athletes

A Literature Review on the Role of Totally Extraperitoneal Repairs for Groin Pain in Athletes

Hybrid mesh for sports hernia repair

Groin Pain Syndrome Known as Sports Hernia

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