TITLE

Adductor-Related Groin Pain in Recreational Athletes: Role of the Adductor Enthesis, Magnetic Resonance Imaging, and Entheseal Pubic Cleft Injections

AUTHOR(S)
Schilders, Ernest; Talbot, J. Charles; Robinson, Philip; Dimitrakopoulou, Alexandra; Gibbon, Wayne William; Bismil, Quamar
PUB. DATE
October 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Oct2009, Vol. 91-A Issue 10, p2455
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Adductor dysfunction can cause groin pain in athletes and may emanate from the adductor enthesis. Adductor enthesopathy may be visualized with magnetic resonance imaging and may be treated with entheseal pubic cleft injections. We have previously reported that pubic cleft injections can provide predictable pain relief at one year in competitive athletes who have no evidence of enthesopathy on magnetic resonance imaging and immediate relief only in patients with findings of enthesopathy on magnetic resonance imaging. In this follow-up study, we attempted to determine if the same holds true for recreational athletes. Methods: We reviewed a consecutive case series of twenty-eight recreational athletes who had presented to our sports medicine clinic with groin pain secondary to adductor longus dysfunction. A period of conservative treatment had failed for all of these athletes. The adductor longus origin was assessed with magnetic resonance imaging for the presence or absence of enthesopathy. All patients were treated with a single pubic cleft injection of a local anesthetic and corticosteroid into the adductor enthesis. The patients were assessed for recurrence of symptoms at one year after treatment. Results: On clinical reassessment five minutes after the injection, all twenty-eight athletes reported resolution of the groin pain. Fifteen patients (Group 1) had no evidence of enthesopathy on magnetic resonance imaging, and thirteen patients (Group 2) had findings of enthesopathy on magnetic resonance imaging. At one year after the injection, five of the fifteen patients in Group 1 had experienced a recurrence; these recurrences were noted at a mean of fourteen weeks (range, seven to twenty weeks) after the injection. Four of the thirteen patients in Group 2 had experienced a recurrence of the symptoms at one year, and these recurrences were noted at a mean of eight weeks (range, two to nineteen weeks) after the injection. Overall, nineteen (68%) of the twenty-eight athletes had a good result following the injection. Of the remaining nine athletes, two were treated successfully with repeat injection; therefore, overall, twenty-one (75%) of the twenty-eight athletes had a good result after entheseal pubic cleft injection. Conclusions: Most recreational athletes with adductor enthesopathy have pain relief at one year after entheseal pubic cleft injection, regardless of the findings on magnetic resonance imaging. There were similarities between this group of recreational athletes and the competitive athletes in our previous study, in that the adductor enthesis was the source of pain and entheseal pubic cleft injection was a valuable treatment option. The main difference was that, in this group of recreational athletes, magnetic resonance imaging evidence of adductor enthesopathy did not correlate with the outcome of the injection. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
44532505

 

Related Articles

  • Fixation with autogenous osteochondral grafts for the treatment of osteochondritis dissecans (stages III and IV). Fonseca, Fernando; Balacó, Inês // International Orthopaedics;Feb2009, Vol. 33 Issue 1, p139 

    This paper presents a clinical and functional assessment of the cases of osteochondritis dissecans (OCD) treated with small mosaicplasty type osteochondral grafts. Between 1999 and 2004, we operated on 12 knees with OCD stages III and IV. They were assessed using the International Cartilage...

  • Interior landscape. Otis, Carol L. // Shape;May93, Vol. 12 Issue 9, p50 

    Asserts that magnetic resonance imaging or MRI is a very helpful tool in diagnosis, especially in sports medicine. Why MRI is useful; Advantages of using MRI; How MRI functions; Importance of submitting detailed record of medical history before using MRI; Importance of absence of metals when...

  • Quadrilateral Space Syndrome. Manske, Robert C.; Sumler, Afton; Runge, Jodi // Athletic Therapy Today;Mar2009, Vol. 14 Issue 2, p45 

    The article discusses quadrilateral space syndrome (QSS), a rare sports injury which creates shoulder pain in athletes who engage in frequent overhead motions such as tennis and baseball players. It is created by compression of the artery and nerve within the quadrilateral of the shoulder. A...

  • A 33-year-old baseball pitcher with elbow pain. Bhatia, Sanjeev; Hsu, Andrew R.; Bush-Joseph, Charles A. // Orthopedics Today;Jul2013, Vol. 33 Issue 7, p50 

    The article discusses the clinical case of a 33 year old baseball pitcher who complains of elbow pain.

  • Reconstruction of multiple myeloma lesions around the pelvis and acetabulum. Sakellariou, Vasileios; Mavrogenis, Andreas; Savvidou, Olga; Sim, Franklin; Papagelopoulos, Panayiotis // European Journal of Orthopaedic Surgery & Traumatology;May2015, Vol. 25 Issue 4, p643 

    Multiple myeloma is a malignancy of monoclonal plasma cells (plasma cells are of B-lymphocyte lineage of the hematopoietic system). It is the second most prevalent blood malignancy after non-Hodgkin's lymphoma. It accounts for approximately 1 % of all malignancies and 2 % of all cancer deaths....

  • Sports injury remedies. Calechman, Steve // Natural Health;Jan/Feb2000, Vol. 30 Issue 1, p113 

    Focuses on natural remedies for the four common types of sports injuries namely, strains, sprains, and tendinitis, muscle aches, bone and joint pain and cuts, abrasions, bruises and blisters. Rest, Ice, Compression and Elevation (RICE) as the first step in treatment; Supplements to minimize...

  • Bitter medicine. Nocera, Joseph // Sports Illustrated;11/6/95, Vol. 83 Issue 20, p74 

    Examines how sports doctors, eager to hold on to their valuable sideline practices, too often strive the help the club, not heal the player. Torturous ethical dilemmas they face; Details on lawsuits involving baseball's Marty Barrett and Dr. Arthur Pappas; Football's Rom Morris and Dr. Christ...

  • Pearls.  // Physician & Sportsmedicine;Feb2000, Vol. 28 Issue 2, p20 

    Recommends several strategies to diagnose or treat sports-related illnesses or injuries. Includes determining whether a swollen knee injury is mild or serious; Management of exercise-related diarrhea in athletes; Use of an oropharynx visualization method to examine the pharynx.

  • Team Physicians Surveyed About Dislocated Joints.  // Athletic Therapy Today;Nov97, Vol. 2 Issue 6, p56 

    Surveys the preferences of orthopedic surgeon team physicians in treating dislocated joints. Treatment of the dislocation in the playing field; Advantages of on-the-field joint relocation; Criteria in the treatment of dislocated joints.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics