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Ellis R, Maskal S, Prabhu A, Petro C, Beffa L, Rosen M, Miller B, Krpata D. Surgical approaches for core abdominal injuries: a review of the Abdominal Core Health Quality Collaborative database. Surg Endosc 2023; 37:8799-8803. [PMID: 37592045 DOI: 10.1007/s00464-023-10350-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/30/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Core abdominal injury (CAI) is a broad term that describes injuries resulting from repetitive loading of the pubis that leads to inflammation, rupture, or destabilization of the core muscles from the pubic bone. There is no clear recommendation on the surgical approach to CAI. We aimed to describe how hernia surgeons within the Abdominal Core Health Quality Collaborative (ACHQC) address this problem surgically and the short-term outcomes. METHODS We queried the ACHQC registry for patients undergoing surgery for isolated CAI and concomitant inguinal hernias (IH) and CAI. Operative approach and quality of life (using EuraHS survey scores) was abstracted. RESULTS A total of 29,451 patients underwent surgery for IHs, CAIs, or both within the registry. Twenty patients underwent surgery for isolated CAI (median age 29, 90% males). Eleven patients (55%) underwent surgery with mesh (four Lichtenstein, three TAPP, and four TEP). Nine patients (45%) underwent tissue-based repairs (four closure of floor, one Bassini, one McVay, one Shouldice, one femoral exploration, and one laparoscopic-to-open conversion). There were no postoperative complications or reoperations within 30 days. EuraHS scores showed improvement at 30 days from baseline (median 29 [6.75-41.75] from 42 [29.42-57.61]). Sixty patients had both IHs and CAIs (median age 31, 97% males). All patients received mesh. Thirty-one patients (52%) underwent open surgery (23 Lichtenstein, 1 plug, 7 TREPP) and 29 underwent minimally invasive repairs (23 TAPP, 6 TEP). There was one seroma at 30 days. EuraHS scores showed improvement at 30 days from baseline (median 16 [5.17-27.33] from 37.5 [26.44-46.58]). CONCLUSIONS Despite technical variability, CAIs with or without concomitant IH generally undergo operations commonly used for IH repairs. Within our series, there was inconsistency with approach and mesh placement. Future work should be focused on standardizing the approach to CAI and capturing long-term data within the ACHQC.
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Affiliation(s)
- Ryan Ellis
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
| | - Sara Maskal
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Ajita Prabhu
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Clayton Petro
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Lucas Beffa
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Michael Rosen
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Benjamin Miller
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - David Krpata
- Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA
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Kopscik M, Crisman JL, Lomasney L, Smith S, Jadidi S. Sports Hernias: A Comprehensive Review for Clinicians. Cureus 2023; 15:e43283. [PMID: 37692688 PMCID: PMC10492628 DOI: 10.7759/cureus.43283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Sports hernias are a complex cause of chronic groin pain in athletes, posing diagnostic and treatment challenges for clinicians. This review article synthesizes current knowledge on sports hernias, exploring pathogenesis, diagnostic approaches, and management strategies. Despite the growing body of research, sports hernias continue to present a significant challenge, necessitating a multidisciplinary approach and further research to improve clinical outcomes. This comprehensive review aims to equip clinicians with an updated understanding of sports hernias, ensuring optimal patient care and informing future research.
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Affiliation(s)
- Michael Kopscik
- Family & Community Medicine, AnMed Health Medical Center, Anderson, USA
| | - Joseph L Crisman
- Family & Community Medicine, Loyola University Medical Center, Chicago, USA
| | - Laurie Lomasney
- Musculoskeletal Imaging, Interventional Radiology, Diagnostic Radiology, Loyola University Medical Center, Chicago, USA
| | - Sean Smith
- Musculoskeletal Radiology, Superior Sports Radiology, Greenville, USA
| | - Shaheen Jadidi
- Sports Medicine, Edward-Elmhurst Health/NorthShore University HealthSystem, Chicago, USA
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Palumbo P, Massimi F, Lucchese S, Grimaldi S, Vernaccini N, Cirocchi R, Sorrenti S, Usai S, Intini SG. Open Surgery for Sportsman’s Hernia a Retrospective Study. Front Surg 2022; 9:893390. [PMID: 35784930 PMCID: PMC9243487 DOI: 10.3389/fsurg.2022.893390] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Sportsman’s hernia is a painful syndrome in the inguinal area occurring in patients who play sports at an amatorial or professional level. Pain arises during sport, and sometimes persists after activity, representing an obstacle to sport resumption. A laparoscopic/endoscopic approach is proposed by many authors for treatment of the inguinal wall defect. Aim of this study is to assess the open technique in terms of safety and effectiveness, in order to obtain the benefit of an open treatment in an outpatient management. From October 2017 to July 2019, 34 patients underwent surgery for groin pain syndrome. All cases exhibited a bulging of the inguinal posterior wall. 14 patients were treated with Lichtenstein technique with transversalis fascia plication and placement of a polypropylene mesh fixed with fibrin glue. In 20 cases, a polypropylene mesh was placed in the preperitoneal space. The procedure was performed in day surgery facilities. Early or late postoperative complications did not occur in both groups. All patients returned to sport, in 32 cases with complete pain relief, whereas 2 patients experienced mild residual pain. The average value of return to sport was 34.11 ± 8.44 days. The average value of return to play was 53.82 ± 11.69 days. With regard to postoperative pain, no substantial differences between the two techniques were detected, and good results in terms of the resumption of sport were ensured in both groups. Surgical treatment for sportsman’s hernia should be considered only after the failure of conservative treatment. The open technique is safe and allows a rapid postoperative recovery.
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Affiliation(s)
- Piergaspare Palumbo
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
- Correspondence: Piergaspare Palumbo
| | - Fanny Massimi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Lucchese
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Serena Grimaldi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Roberto Cirocchi
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Sofia Usai
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
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Kraeutler MJ, Mei-Dan O, Belk JW, Larson CM, Talishinskiy T, Scillia AJ. A Systematic Review Shows High Variation in Terminology, Surgical Techniques, Preoperative Diagnostic Measures, and Geographic Differences in the Treatment of Athletic Pubalgia/Sports Hernia/Core Muscle Injury/Inguinal Disruption. Arthroscopy 2021; 37:2377-2390.e2. [PMID: 33845134 DOI: 10.1016/j.arthro.2021.03.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To perform a systematic review of reported terminologies, surgical techniques, preoperative diagnostic measures, and geographic differences in the treatment of core muscle injury (CMI)/athletic pubalgia/inguinal disruption. METHODS A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies or articles that described a surgical technique to treat CMI refractory to nonoperative treatment. The search phrase used was "core muscle injury" OR "sports hernia" OR "athletic pubalgia" OR "inguinal disruption." The diagnostic terminology, country of publication, preoperative diagnostic measures, surgical technique, and subspecialty of the operating surgeons described in each article were extracted and reported. RESULTS Thirty-one studies met the inclusion and exclusion criteria, including 3 surgical technique articles and 28 clinical articles (2 Level I evidence, 1 Level II, 4 Level III, and 21 Level IV). A total of 1,571 patients were included. The most common terminology used to describe the diagnosis was "athletic pubalgia," followed by "sports hernia." Plain radiographs and magnetic resonance imaging of the pelvis were the most common imaging modalities used in the preoperative evaluation of CMI/athletic pubalgia/inguinal disruption. Tenderness-to-palpation testing was the most common technique performed during physical examination, although the specific locations assessed with this technique varied substantially. The operating surgeons were general surgeons (16 articles), a combination of orthopaedic and general surgeons (7 articles), or orthopaedic surgeons (5 articles). The most common procedures performed were open or laparoscopic mesh repair, adductor tenotomy, primary tissue (hernia) repair, and rectus abdominis repair. The procedures performed differed on the basis of surgeon subspecialty, geographic location, and year of publication. CONCLUSIONS A variety of diagnostic methods and surgical procedures have been used in the treatment of a CMI/athletic pubalgia/sports hernia/inguinal disruption. These procedures are performed by orthopaedic and/or general surgeons, with the procedures performed differing on the basis of surgeon subspecialty and geographic location. LEVEL OF EVIDENCE Level V, systematic review of Level I to V studies.
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Affiliation(s)
- Matthew J Kraeutler
- Department of Orthopaedic Surgery, St Joseph's University Medical Center, Paterson, New Jersey, U.S.A..
| | - Omer Mei-Dan
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, U.S.A
| | - John W Belk
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, U.S.A
| | | | - Toghrul Talishinskiy
- Department of Surgery, St Joseph's University Medical Center, Paterson, New Jersey, U.S.A
| | - Anthony J Scillia
- Department of Orthopaedic Surgery, St Joseph's University Medical Center, Paterson, New Jersey, U.S.A.; New Jersey Orthopaedic Institute, Wayne, New Jersey, U.S.A
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Affiliation(s)
- Brian S. Zuckerbraun
- Division of General and Trauma Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- Surgical Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Anthony R. Cyr
- Division of General and Trauma Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Craig S. Mauro
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Santilli O, Santilli H, Nardelli N, Tripoloni D, Etchepare H. Sports rehabilitation after laparoscopic hernioplasty. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2020. [DOI: 10.4103/ijawhs.ijawhs_28_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abouelnaga WA, Aboelnour NH. Effectiveness of Active Rehabilitation Program on Sports Hernia: Randomized Control Trial. Ann Rehabil Med 2019; 43:305-313. [PMID: 31311252 PMCID: PMC6637051 DOI: 10.5535/arm.2019.43.3.305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/27/2018] [Indexed: 01/26/2023] Open
Abstract
Objective To determine whether an active rehabilitation program that involves repetitive effortful muscle contractions, including core stability, balancing exercises, progressive resistance exercises, and running activities, after a sports hernia, is effective. Methods Forty soccer players with sports hernias were randomly divided into two equal groups: group A (active rehabilitation program) and group B (conventional treatment). The methods of assessment included a visual analog scale (VAS) and hip internal and external range of motion assessments. Group A received conventional treatment (heat, massage, transcutaneous electrical nerve stimulation, and mobilization) plus an active rehabilitation program, while group B received only conventional treatment. Three treatment sessions were given each week for 2 months. Evaluations were performed pre- and post-treatment. Results A decrease in VAS was seen in both groups at the end of treatment, 80.25% in group A and 41.93% in group B. The difference between the two groups was statistically significant (p=0.0001), whereas there were no statistical differences in internal and external rotation between the groups at the end of treatment (p>0.05). After treatment, an improvement in outcome measures of group A compared to group B (p=0.01) was seen. Thirteen patients in group A and only three patients in group B returned to sports activities without groin pain. Conclusion Active rehabilitation was effective for sports hernia management measured by a decrease in pain and the return to sports.
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Affiliation(s)
- Walid Ahmed Abouelnaga
- Physical Therapy Department for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nancy Hassan Aboelnour
- Physical Therapy Department for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Treatment of longstanding groin pain: a systematic review. Hernia 2019; 23:1035-1044. [DOI: 10.1007/s10029-019-01919-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
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9
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Otten R, Vuckovic Z, Weir A, Serner A. Rehabilitation and Return to Play Following Surgery for Inguinal-Related Groin Pain. OPER TECHN SPORT MED 2017. [DOI: 10.1053/j.otsm.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bisciotti GN, Volpi P, Zini R, Auci A, Aprato A, Belli A, Bellistri G, Benelli P, Bona S, Bonaiuti D, Carimati G, Canata GL, Cassaghi G, Cerulli S, Delle Rose G, Di Benedetto P, Di Marzo F, Di Pietto F, Felicioni L, Ferrario L, Foglia A, Galli M, Gervasi E, Gia L, Giammattei C, Guglielmi A, Marioni A, Moretti B, Niccolai R, Orgiani N, Pantalone A, Parra F, Quaglia A, Respizzi F, Ricciotti L, Pereira Ruiz MT, Russo A, Sebastiani E, Tancredi G, Tosi F, Vuckovic Z. Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete. BMJ Open Sport Exerc Med 2016; 2:e000142. [PMID: 28890800 PMCID: PMC5566259 DOI: 10.1136/bmjsem-2016-000142] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/14/2022] Open
Abstract
The nomenclature and the lack of consensus of clinical evaluation and imaging assessment in groin pain generate significant confusion in this field. The Groin Pain Syndrome Italian Consensus Conference has been organised in order to prepare a consensus document regarding taxonomy, clinical evaluation and imaging assessment for groin pain. A 1-day Consensus Conference was organised on 5 February 2016, in Milan (Italy). 41 Italian experts with different backgrounds participated in the discussion. A consensus document previously drafted was discussed, eventually modified, and finally approved by all members of the Consensus Conference. Unanimous consensus was reached concerning: (1) taxonomy (2) clinical evaluation and (3) imaging assessment. The synthesis of these 3 points is included in this paper. The Groin Pain Syndrome Italian Consensus Conference reached a consensus on three main points concerning the groin pain syndrome assessment, in an attempt to clarify this challenging medical problem.
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Affiliation(s)
- G N Bisciotti
- Qatar Orthopedic and Sport Medicine Hospital, Doha, Qatar
| | - P Volpi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.,FC Internazionale, Milan, Italy
| | - R Zini
- Azienda Ospedaliera "Ospedale San Salvatore", Pesaro, Italy
| | - A Auci
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | | | - A Belli
- FC Internazionale, Milan, Italy
| | | | | | - S Bona
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - D Bonaiuti
- Fisioclinic Centro Medico Polispecialistico, Pesaro, Italy
| | - G Carimati
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | | | - G Cassaghi
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | - S Cerulli
- Institute of Sports Medicine of Turin, Italy
| | - G Delle Rose
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | | | - F Di Marzo
- Azienda Ospedaliera Universitaria di Udine, Italy
| | | | - L Felicioni
- Ospedale della Misericordia, Grosseto, Italy
| | | | - A Foglia
- Studio di fisioterapia Riabilita, Pesaro, Italy
| | - M Galli
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | - L Gia
- Azienda Ospedaliera Universitaria di Udine, Italy
| | | | - A Guglielmi
- Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - A Marioni
- Azienda Policlinico Università di Bari, Bari, Italy
| | | | | | - N Orgiani
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | | | - F Parra
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | - A Quaglia
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - F Respizzi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - L Ricciotti
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | | | | | | | | | - F Tosi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - Z Vuckovic
- Qatar Orthopedic and Sport Medicine Hospital, Doha, Qatar
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Serner A, van Eijck CH, Beumer BR, Hölmich P, Weir A, de Vos RJ. Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 2015; 49:813. [PMID: 25633830 PMCID: PMC4484372 DOI: 10.1136/bjsports-2014-094256] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2015] [Indexed: 01/08/2023]
Abstract
Background Groin pain in athletes is frequent and many different treatment options have been proposed. The current level of evidence for the efficacy of these treatments is unknown. Objective Systematically review the literature on the efficacy of treatments for groin pain in athletes. Methods Nine medical databases were searched in May 2014. Inclusion criteria: treatment studies in athletes with groin pain; randomised controlled trials, controlled clinical trials or case series; n>10; outcome measures describing number of recovered athletes, patient satisfaction, pain scores or functional outcome scores. One author screened search results, and two authors independently assessed study quality. A best evidence synthesis was performed. Relationships between quality score and outcomes were evaluated. Review registration number CRD42014010262. Results 72 studies were included for quality analysis. Four studies were high quality. There is moderate evidence that, for adductor-related groin pain, active exercises compared with passive treatments improve success, multimodal treatment with a manual therapy technique shortens the time to return to sports compared with active exercises and adductor tenotomy improves treatment success over time. There is moderate evidence that for athletes with sportsman's hernia, surgery results in better treatment success then conservative treatment. There was a moderate and inverse correlation between study quality and treatment success (p<0.001, r=−0.41), but not between study quality and publication year (p=0.09, r=0.20). Conclusions Only 6% of publications were high quality. Low-quality studies showed significantly higher treatment success and study quality has not improved since 1985. There is moderate evidence for the efficacy of conservative treatment (active exercises and multimodal treatments) and for surgery in patients with adductor-related groin pain. There is moderate evidence for efficacy of surgical treatment in sportsman's hernia.
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Affiliation(s)
- Andreas Serner
- Aspetar Sports Groin Pain Center, Orthopaedic and Sports Medicine Hospital, Doha, Qatar Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Casper H van Eijck
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Berend R Beumer
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Per Hölmich
- Aspetar Sports Groin Pain Center, Orthopaedic and Sports Medicine Hospital, Doha, Qatar Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Adam Weir
- Aspetar Sports Groin Pain Center, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Robert-Jan de Vos
- Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Economopoulos KJ, Milewski MD, Hanks JB, Hart JM, Diduch DR. Sports hernia treatment: modified bassini versus minimal repair. Sports Health 2014; 5:463-9. [PMID: 24427419 PMCID: PMC3752188 DOI: 10.1177/1941738112473429] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: The minimal repair technique for sports hernias repairs only the weak area of the posterior abdominal wall along with decompressing the genitofemoral nerve. This technique has been shown to return athletes to competition rapidly. This study compares the clinical outcomes of the minimal repair technique with the traditional modified Bassini repair. Hypothesis: Athletes undergoing the minimal repair technique for a sports hernia would return to play more rapidly compared with athletes undergoing the traditional modified Bassini repair. Methods: A retrospective study of 28 patients who underwent sports hernia repair at the authors’ institution was performed. Fourteen patients underwent the modified Bassini repair, and a second group of 14 patients underwent the minimal repair technique. The 2 groups were compared with respect to time to return to sport, return to original level of competition, and clinical outcomes. Results: Patients in the minimal repair group returned to sports at a median of 5.6 weeks (range, 4-8 weeks), which was significantly faster compared with the modified Bassini repair group, with a median return of 25.8 weeks (range, 4-112 weeks; P = 0.002). Thirteen of 14 patients in the minimal repair group returned to sports at their previous level, while 9 of 14 patients in the Bassini group were able to return to their previous level of sport (P = 0.01). Two patients in each group had recurrent groin pain. One patient in the minimal repair group underwent revision hernia surgery for recurrent pain, while 1 patient in the Bassini group underwent hip arthroscopy for symptomatic hip pain. Conclusion: The minimal repair technique allows athletes with sports hernias to return to play faster than patients treated with the modified Bassini.
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Affiliation(s)
| | - Matthew D Milewski
- Elite Sports Medicine, Connecticut Children's Medical Center, Farmington, Connecticut
| | - John B Hanks
- Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Joseph M Hart
- Department of Orthopaedics, University of Virginia, Charlottesville, Virginia
| | - David R Diduch
- Department of Orthopaedics, University of Virginia, Charlottesville, Virginia
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Bernhardt GA, Gruber G, Molderings BS, Cerwenka H, Glehr M, Giessauf C, Kornprat P, Leithner A, Mischinger HJ. Health-related quality of life after TAPP repair for the sportsmen's groin. Surg Endosc 2013; 28:439-46. [PMID: 24061625 DOI: 10.1007/s00464-013-3190-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 08/11/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sportsmen's groin (SG) is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor in the absence of a groin hernia. Long-term results for laparoscopic inguinal hernia repair, especially data on health-related quality of life (HRQOL), are scant and there are no available data whatsoever on HRQOL after SG. The main goal of this study was to compare postoperative QOL data in the long term after transabdominal preperitoneal hernioplasty (TAPP) in groin hernia and SG patients with QOL data of a normal population. METHODS This study included all patients (n = 559) who underwent TAPP repair between 2000 and 2005. Forty seven patients (8.4 %) were operated on for SG. We sent out the Short Form 36 Health Survey (SF-36) questionnaire for QOL evaluation. QOL data were compared with data from an age- and sex-matched normal population. RESULTS Ultimately, 383 completed questionnaires were available for evaluation (69 % response rate). The mean follow-up time was 94 ± 20 months. In the SG group there were statistically significant differences in three subscales of the SF-36 and the mental component summary measure, showing better results for the SG group compared to the sex- and age-matched normal group data. There were no statistically significant differences between groin hernia patients and the sex- and age-matched normal population. CONCLUSION TAPP repair for SG as well as groin hernia results in good HRQOL in the long term. Results for SG patients are comparable with QOL data of a normal population or even better.
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Affiliation(s)
- Gerwin A Bernhardt
- Division of General Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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