Surgical treatment of chronic groin pain in athletes

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.

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Chronic Groin Pain - Soccer

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000385679.09590.da ◽

2010 ◽

Vol 42 ◽

pp. 222

Author(s):

Navid Mahooti

Keyword(s):

Groin Pain ◽

Chronic Groin Pain

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Chronic groin pain in an athlete: an unusual presentation

British Journal of Sports Medicine ◽

10.1136/bjsm.32.2.182 ◽

1998 ◽

Vol 32 (2) ◽

pp. 182-183

Author(s):

E. V. Williams ◽

P. Windless ◽

S. Blease ◽

K. Queen ◽

T. Jenkinson

Keyword(s):

Groin Pain ◽

Unusual Presentation ◽

Chronic Groin Pain

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P081 CHRONIC GROIN PAIN IN SPORTSMEN. EVIDENCE-BASED IN EXPERIENCE

British Journal of Surgery ◽

10.1093/bjs/znab395.076 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Osvaldo Santilli ◽

Hernán Santilli ◽

Rodolfo Scaravonati ◽

Nicolás Nardelli ◽

Hernán Etchepare

Keyword(s):

Groin Pain ◽

Treatment Algorithm ◽

Postoperative Recovery ◽

Chronic Groin Pain ◽

Total Recovery ◽

Ultrasound Findings ◽

Common Causes ◽

Assessment And Treatment ◽

Sportsman’S Hernia ◽

Low Sensitivity

Abstract Aim The main objective of this study is to describe and analyze the assessment and treatment of chronic groin pain (CGP) based on the experience collected in 20 years. Material and Methods Descriptive, observational, and retrospective study. It is a multidisciplinary team formed by surgeons, physiotherapists, orthopedists, and imaging specialists. That had developed an assessment, diagnosis, and treatment algorithm for (CGP), which have been implemented for more than 20 years. Follow-up included a record of clinical examination findings, clinical entities diagnosed, ultrasound findings, physiotherapy treatment, operation notes, and postoperative recovery, time to return to sporting activity, and complications. Results In the period between August 2000 and August 2020, we assessed 9996 patients with CGP. (91%) men and (9%) women with a mean age of 30 (SD: 11.21). The most frequently practiced sports were: football (43%), rugby (25%), tennis (12%). The most frequent clinical entities registered were tendinopathies (69%): iliopsoas-pectineus- related (36%) and adductor-related (33%). Tendinopathy sports rehabilitation treatment: (95.7%) presented total recovery in 45 days; 260 patients (4.3%)intra-tissue percutaneous electrolysis was used with favorable recovery. Only 16 patients required tenotomies The ultrasound has been used to detect signs of adductor tendinopathy (92%) and sportsman hernia, but has low sensitivity in iliopsoas-pectineus tendinopathy (21%). Conclusions The algorithm used has proven to be safe and successful. Tendinopathies and Sportsman's hernia are the most common causes of chronic groin pain in sportsmen, presenting together in 82% of the cases. TAPP hernioplasty repair, followed by physical rehabilitation offered excellent results to treat sportsman hernia.

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A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

International Surgery Journal ◽

10.18203/2349-2902.isj20180835 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1083

Author(s):

Samrat Sunkar ◽

Dick B. S. Brashier ◽

Kiran Bhagwat ◽

Vipin Sharma ◽

Piyush Angrish

Keyword(s):

Groin Pain ◽

Sensory Loss ◽

Chronic Groin Pain ◽

Inguinal Hernioplasty ◽

Nerve Preservation ◽

Pain Disability ◽

Group A ◽

Group B ◽

Mesh Hernioplasty

Background: Residual neuralgia, called as Inguinodynia, is an important complication unique to groin hernia repair. The reported incidence ranges between 9-63%. The symptoms are potentially disabling. Symptoms are often more pronounced on axial twisting of body. Methods for prevention include identification and preservation of all nerves, Ilioinguinal Neurectomy and triple Neurectomy during surgery.Methods: One hundred patients underwent elective unilateral Lichtenstein’s tension free hernioplasty. 50 patients were subjected to elective ilioinguinal neurectomy. The remaining underwent standard Liechtenstein’s mesh hernioplasty, without ilioinguinal neurectomy. Randomization was achieved by allocating alternate patients to each group - prophylactic neurectomy, or nerve preservation. All patients, during each review were asked to fill out a Pain Disability Questionnaire to assess sensory loss and pain disability objectively.Results: At completion of 6 monthly follow up pain at rest (none in group ‘A’ compared with 3 in group ‘B’), after coughing 5 times (none in group ‘A’ compared with 7 in group ‘B’), after climbing 4 flights of stairs(3 in group ‘A’ compared with 16 in group ‘B’) and after cycling for 20 minutes (11 in group ‘A’ compared with 22 in group ‘B’) were all significantly lesser in the neurectomy group as compared with the non neurectomy group. More importantly, exertional chronic pain incidence at 6 months was significantly less in group ‘A’.Conclusions: It was concluded that pain after inguinal mesh hernioplasty is a cause of morbidity, pain was complained of by a significantly larger number of non-neurectomised patients at 6 months of follow-up, prophylactic ilioinguinal neurectomy is associated with reduced exertional chronic groin pain, disability caused by pain after inguinal hernioplasty, is significantly reduced by ilioinguinal neurectomy and an extremely significant reduction in the requirement of medication is brought about by neurectomy compared with controls.

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Prevention and Evaluation of Chronic Groin Pain

Textbook of Hernia ◽

10.1007/978-3-319-43045-4_18 ◽

2017 ◽

pp. 141-145

Author(s):

Giampiero Campanelli ◽

Marta Cavalli ◽

Piero Giovanni Bruni ◽

Andrea Morlacchi

Keyword(s):

Groin Pain ◽

Chronic Groin Pain

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Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

The Journal of Hip Surgery ◽

10.1055/s-0038-1676307 ◽

2018 ◽

Vol 02 (04) ◽

pp. 156-166

Author(s):

Tai Holland ◽

Holly Thomas-Aitken ◽

Jessica Goetz ◽

Michael Willey

Keyword(s):

Surgical Treatment ◽

Hip Dysplasia ◽

Groin Pain ◽

Periacetabular Osteotomy ◽

Hip Pain ◽

Acetabular Retroversion ◽

Short Term ◽

Radiographic Findings ◽

Lateral Hip Pain

AbstractBorderline hip dysplasia and acetabular retroversion are common radiographic findings in young individuals with and without hip pain. Orthopaedic surgeons should be knowledgeable about the radiographic findings, diagnosis, and appropriate nonsurgical and surgical treatment of these conditions. Borderline hip dysplasia is generally defined by a lateral center edge angle of Wiberg from 20 to 25° (some define as 18–25°) and is a cause of joint microinstability. The degree of soft tissue laxity can have significant implications for joint stability in patients with borderline hip dysplasia. The most common presenting symptoms are groin pain and lateral hip pain. Acetabular retroversion is defined by radiographic findings of crossover sign, ischial spine sign, and posterior wall sign. Individuals with symptomatic retroversion have a clinical presentation consistent with impingement, groin pain with flexion activities, and less commonly lateral hip pain. Physical therapy has been shown to improve symptoms in a subset of individuals with these conditions. There are multiple recent publications about arthroscopic treatment of patients with borderline hip dysplasia. These reports generally find that good short-term outcomes can be expected when using arthroscopic techniques that include labral preservation/repair and capsular plication. There are limited reports of periacetabular osteotomy as a treatment for borderline hip dysplasia. Publications focusing specifically on surgical treatment of acetabular retroversion are also infrequent. Periacetabular osteotomy has been shown to have superior long-term clinical outcomes to surgical hip dislocation with anterior rim trimming in patients with all three radiographic findings of retroversion. Arthroscopic treatment has been shown to have good short-term outcomes. Future work in the areas of borderline hip dysplasia and acetabular retroversion should focus on reporting long-term clinical follow-up of these surgical treatments and using computation techniques as a tool to determine appropriate surgical and nonsurgical treatment for each individual patient.

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