Sports hernia

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Pubalgia is a general term used to describe severe groin and hip pain in the professional athlete. The etiology of this condition can range from adductor tendon injuries, to hip injuries, to abdominal wall injuries. One of the least understood and most perplexing problems is the sports hernia. This diagnosis should be considered in athletes who do not respond to conservative treatment of pubalgia. Only recently has this entity become a known cause of persistent groin pain in the athlete. Some surgeons still do not believe this condition exists. We evaluated 96 professional athletes who underwent surgery for sports hernias. Thirty patients (31%) had adductor pain associated with either lower abdominal or inguinal pain. There were 92 patients (96%) who returned to their preinjury levels of performance. One should not offer surgery unless the groin pain has been present for at least 3 months. The authors describe the laparoscopic preperitoneal approach to repair these injuries. With the proper method of diagnosis and the expertise of an experienced laparoscopic surgeon, the athlete can return to active participation in sports within 3 to 6 weeks after surgery.

Section snippets

Data analysis

The patients that had surgical treatment from 1998 to 2003 served as our database for the study. All 96 patients were followed by office visits, contact with team trainers, or by personal interviews with the athletes and were followed until the athletes returned to previous levels of competition. Only 25 of the patients (26%) were interviewed after surgery by the authors. Patients operated on after December 2000 were not included in this database because of incomplete follow-up. Successful

Results

Ninety-three patients (97%) returned to preinjury levels of performance with little or no pain. One patient had adductor release surgery 4 months after laparoscopic repair. Two patients had little relief of their symptoms at 6 months after surgical repair. It is of interest that both failures were soccer players who returned to play and complained of similar pain and restriction of activity as before their surgical correction. Two patients had a previous open repair for their sports hernia,

Discussion

Athletic pubalgia syndrome consists of lower abdominal or groin pain often associated with adductor tendon complaints. It was first described in the European literature3 and followed in the American literature in the early 1990s.4 The treatment of sports hernias is surgical repair of the inguinal floor. No repair should be attempted until conservative measures have failed. The earliest repair should not be attempted before 6 to 8 weeks of conservative treatment. All of the repairs in this study

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There are more references available in the full text version of this article.

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