Surgical Treatment of Sports Hernia: Laparoscopic Approach

Paajanen, Hannu; Montgomery, Agneta

doi:10.1007/978-1-4899-7421-1_12

Sports Hernia and Athletic Pubalgia 2014

DOI: 10.1007/978-1-4899-7421-1_12

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Surgical Treatment of Sports Hernia: Laparoscopic Approach

Hannu Paajanen

Agneta Montgomery

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2018

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“…Historically, this was felt to be symptomatic inguinal canal insufficiency without true herniation, and treatment was based on standard hernia repair techniques. 4 , 7 , 8 , 11 , 23 In addition to other sources of groin pain, this specific injury to the aponeurotic plate is becoming more recognized as a distinct tendinous injury, thus requiring more specific structural repair.…”

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confidence: 99%

Athletic Pubalgia Secondary to Rectus Abdominis–Adductor Longus Aponeurotic Plate Injury: Diagnosis, Management, and Operative Treatment of 100 Competitive Athletes

Emblom

Mathis²,

Aune

2018

Orthopaedic Journal of Sports Medicine

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Background:A rectus abdominis–adductor longus (RA-AL) aponeurotic plate injury, commonly associated with athletic pubalgia, sports hernia, or a core muscle injury, causes significant dysfunction in athletes. Increased recognition of this specific injury distinct from inguinal hernia abnormalities has led to better management of this debilitating condition.Hypothesis:Surgical repair of RA-AL aponeurotic plate injuries will result in decreased symptoms and high rates of return to play.Study Design:Case series; Level of evidence, 4.Methods:Using our billing and clinical database, patients who underwent RA-AL aponeurotic plate repair by a single surgeon at a single institution were contacted for Hip Outcome Score (HOS) and return-to-play data. Patients with a confirmed diagnosis by history, physical examination, and magnetic resonance imaging who failed 6 to 12 weeks of appropriate conservative treatment were indicated for surgery. Surgical repair involved adductor longus fractional lengthening, limited adductor longus tenotomy, and a turn-up flap of the released adductor tendon and aponeurosis onto the rectus abdominis for imbrication reinforcement.Results:Of 100 patients who met the inclusion criteria, 85 (85%) were contacted. A total of 82 (96%) patients were able to return to play at a mean of 4.1 months after repair. Hip function was rated as 98% of normal and sports function as 92% of normal. Factors associated with negative outcomes were multiple procedures, prior inguinal hernia repair, and female sex. Negative outcomes were demonstrated by decreased HOS scores and decreased sports function. The overall complication rate was 7%.Conclusion:RA-AL aponeurotic plate repair by the method of an adductor-to–rectus abdominis turn-up flap is a safe procedure with high return-to-play success. Patients who had previously undergone inguinal hernia repair or other hip/pelvic-related surgery and female patients had worse outcomes.

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mentioning

confidence: 99%

Athletic Pubalgia Secondary to Rectus Abdominis–Adductor Longus Aponeurotic Plate Injury: Diagnosis, Management, and Operative Treatment of 100 Competitive Athletes

Emblom

Mathis²,

Aune

2018

Orthopaedic Journal of Sports Medicine

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Surgical Treatment of Sports Hernia: Laparoscopic Approach

Cited by 1 publication

References 36 publications

Athletic Pubalgia Secondary to Rectus Abdominis–Adductor Longus Aponeurotic Plate Injury: Diagnosis, Management, and Operative Treatment of 100 Competitive Athletes

Athletic Pubalgia Secondary to Rectus Abdominis–Adductor Longus Aponeurotic Plate Injury: Diagnosis, Management, and Operative Treatment of 100 Competitive Athletes

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