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Sports Hernia Repair with Adductor Tenotomy

Robert A Grossman, MD, Fred Brody, MD, MBA. George Washington University

Introduction: Athletic pubalgia, commonly referred to as a sports hernia, is acute or chronic groin pain localized to the pubic region. It is thought to be due to chronic strain of the rectus abdominis-adductor longus aponeurosis complex. It is generally seen in conjunction with high-impact or continuous athletics; the pain is exacerbated with activity, and on examination these patients generally have tenderness to palpation of the pubic bone. Several methods of repair have been put forward, including mesh-based, laparoscopic, and open repairs. We present a series of 23 patients treated at a single institution and with a single surgeon for athletic pubalgia with a rectus release and adductor tenotomy.

Methods: Twenty-three patients have been referred to a single surgeon for sports hernia repair. All underwent a full workup including a history and physical, with use of magnetic resonance imaging to assess for tendinous inflammation. Patients then undergo an open repair of the sports hernia with or without an adductor tenotomy. All patients are seen at two and four weeks post-operatively, and have phone interview conducted at eight weeks. The attached video demonstrates our surgical technique.

Results: Of twenty-three patients, twenty-one were male. The average age is 34.65 years. Nine patients are recreational athletes, eight patients are long-distance runners; the rest of the patients performed various sports at a collegiate or professional level. All have subsequently returned to full activity.

Conclusion: Rectus release with or without an adductor tenotomy is a viable option for alleviating the pain and chronic strain associated with athletic pubalgia. This procedure is based upon relief of the vector forces from the pubic tubercle and bone by division of the rectus-adductor aponeurosis without the need for mesh. This procedure can be safely and successfully performed in athletes, allowing for return to full activity.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79864

Program Number: V121

Presentation Session: Hernia Video Session

Presentation Type: Video

153

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