Use of Pubic Symphysis Curettage for Treatment-Resistant Osteitis Pubis in Athletes

Abstract

The authors suggest that this relatively simple procedure can be of significant benefit to those athletes wishing to return to their previous levels of physical activity when more nonoperative measures have proven unsuccessful.

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

“…Disc curettage without excessive bone and ligament resection which is less invasive surgery was introduced [3,9]. Radic et al reported 16 of 23 athletes with ''osteitis pubis'' treated by open curettage, returned to full activity.…”

“…It is postulated that increased biomechanical stress during sports activities with stop and go movements, sharp sprints as well as pivoting manoeuvres leads to an overuse injury at the symphysis pubis and the stabilizing ligaments with subsequent degeneration of the fibrocartilaginous disc tissue, resulting in anterior pelvic instability in the end stage [2]. The most favourite sports associated with these activities include soccer, Australian-rules football and to a lesser degree, distance running [1][2][3]. Athletes with osteitis pubis commonly present with anterior and medial groin pain and, in some cases, may have pain centred directly over the pubic symphysis.…”

“…Usually the majority of the cases with osteitis pubis respond well to conservative programs of rest, physiotherapy with core muscle strengthening, oral medication or local injection therapy with corticoids; however, they may often take a considerable period of time to heal [1,3]. However, a small number of athletes may be refractory to these conservative measures and need surgical intervention.…”

“…However, a small number of athletes may be refractory to these conservative measures and need surgical intervention. A variety of surgical procedures with varying efficacies have been reported in the literature, such as wedge resection [6], total resection [7], pubic symphysis stabilization with compression plate and bone grafting [8] and also the least violating surgery which is symphysis pubis curettage [3,9]. However, sole pubic symphysis curettage only resulted in about 70 % improvement and return to previous sport activity [3].…”

Osteitis pubis in elite athletes: Diagnostic and therapeutic approach

“…More specifically haemospermia has been referred in one athlete whilst another one presented intermittent scrotal swelling during exercise [21] . Radic et al [54] retrospectively evaluated the results of pubic symphysis curettage in 23 athletes with recalcitrant OP with a mean result of discomfort of 13.22 mo. Sixteen participants in this study were able to return to full sport activity by a mean of 5.6 mo after this surgical intervention.…”