D Kopelman1,2,3, U Kaplan4, O A Hatoum4,5, N Abaya4, D Karni4, A Berber6, P Sharon6, B Peskin5,6,7. 1. Department of Surgery B, HaEmek Medical Center, Afula, Israel. kopelmand@bezeqint.net. 2. Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. kopelmand@bezeqint.net. 3. Maccabi Haifa Football Club, Sports Medicine Center, Haifa, Israel. kopelmand@bezeqint.net. 4. Department of Surgery B, HaEmek Medical Center, Afula, Israel. 5. Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. 6. Maccabi Haifa Football Club, Sports Medicine Center, Haifa, Israel. 7. Knee and Arthroscopy Unit, Orthopedic Division, Rambam Medical Center, Haifa, Israel.
Abstract
BACKGROUND: Chronic groin pain appears in athletes with a diverse etiology. In a select few, it can be defined as a sportsman's hernia, that may be related, among other pathologies, to weakness of the posterior inguinal wall and may successfully respond to surgery. HYPOTHESIS: Surgical repair of the sportsman's hernia is associated with good functional outcomes, if the diagnosis is based on meticulous examination and follows a simple selection flowchart. STUDY DESIGN: Prospective case cohort study. METHODS: The study assessed patients recruited from 2006 until the present assessed by a dedicated team with clinical and radiographic features of a sportsman's hernia who had failed a specified period of conservative therapies. Surgery was performed using a tension-free mesh open inguinal hernia repair. RESULTS: Of 246 male patients with chronic groin pain, 51 underwent surgery (mean age 20.7 years, range 14-36 years) with 58 inguinal procedures performed. Of the operated group, seven underwent bilateral surgery with a direct hernia found in 9/58 operated sides (15.5%), an indirect hernial sac in 8/58 (14%) and a direct and indirect hernia being found in 3/58 (5%) of operated sides. There was no post-operative morbidity (median follow-up 36.1 months; range 1-74 months), with two failures (3.45 % of operated sides). All other patients were asymptomatic, returned to full sports activity within 4.3 weeks (range 3-8 weeks) after surgery, and required no analgesics or further treatment. CONCLUSION: Selective surgical hernia repair, based on meticulous anamnesis and physical examination is effective in the management of chronic groin pain in athletes.
BACKGROUND: Chronic groin pain appears in athletes with a diverse etiology. In a select few, it can be defined as a sportsman's hernia, that may be related, among other pathologies, to weakness of the posterior inguinal wall and may successfully respond to surgery. HYPOTHESIS: Surgical repair of the sportsman's hernia is associated with good functional outcomes, if the diagnosis is based on meticulous examination and follows a simple selection flowchart. STUDY DESIGN: Prospective case cohort study. METHODS: The study assessed patients recruited from 2006 until the present assessed by a dedicated team with clinical and radiographic features of a sportsman's hernia who had failed a specified period of conservative therapies. Surgery was performed using a tension-free mesh open inguinal hernia repair. RESULTS: Of 246 male patients with chronic groin pain, 51 underwent surgery (mean age 20.7 years, range 14-36 years) with 58 inguinal procedures performed. Of the operated group, seven underwent bilateral surgery with a direct hernia found in 9/58 operated sides (15.5%), an indirect hernial sac in 8/58 (14%) and a direct and indirect hernia being found in 3/58 (5%) of operated sides. There was no post-operative morbidity (median follow-up 36.1 months; range 1-74 months), with two failures (3.45 % of operated sides). All other patients were asymptomatic, returned to full sports activity within 4.3 weeks (range 3-8 weeks) after surgery, and required no analgesics or further treatment. CONCLUSION: Selective surgical hernia repair, based on meticulous anamnesis and physical examination is effective in the management of chronic groin pain in athletes.
Entities:
Keywords:
Groin pain in athletes; Sportsman’s hernia
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