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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Surgical Release of the Adductor Longus With or Without Sports Hernia Repair Is a Useful Treatment for Recalcitrant Groin Strains in the Elite Athlete
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Surgical Release of the Adductor Longus With or Without Sports Hernia Repair Is a Useful Treatment for Recalcitrant Groin Strains in the Elite Athlete

机译：有或没有运动疝修复的外科释放有或没有运动疝修复是精英运动员顽固腹股带的有用处理

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Background: Chronic strain and/or tendinopathy of the adductor longus tendon can be a cause of long-standing groin pain in the elite athlete, resulting in significant time lost from competition. Accurate diagnosis and treatment can expedite return to play. Purpose/Hypothesis: To evaluate return to sport and performance in National Collegiate Athletic Association (NCAA) Division I football players and National Football League (NFL) players following adductor longus release with or without sports hernia repair. We hypothesized that adductor release will be an effective method of treatment for recalcitrant groin/adductor pain in these athletes. Study Design: Case series; Level of evidence, 4. Methods: A cohort study was performed of all NFL players and NCAA Division I college athletes who had undergone an adductor longus tendon release with or without sports hernia repair by 1 of 2 fellowship-trained orthopaedic surgeons between May 1999 and January 2013. All patients reported groin pain below the inguinal ligament and localized to their adductor longus. Symptoms lasted longer than 10 weeks and limited their ability to effectively perform during sport, as assessed by their coach and self-assessment. Questionnaires were given to all 26 patients to assess long-term surgical outcomes. A subgroup analysis was performed for NFL players, in which “performance scores” were calculated according to individual player statistics while playing. Scores obtained before the diagnosis of chronic adductor longus tendinopathy or strain were compared with those after surgery. Patients with prior abdominal or pelvic surgery, radiographic evidence of degenerative joint disease of the hip, labral tears or femoral acetabular impingement, prostatic or urinary tract disease, or nerve entrapment of the ilioinguinal, genitofemoral, or lateral femoral cutaneous nerves were excluded from the study. Results: A total of 32 athletes underwent an adductor longus tenotomy during the study period. Of these patients, 28 were college- or professional-level athletes who underwent an adductor longus tenotomy, with a mean ± SD follow-up time of 6.2 ± 4.2 years (range, 12-178 months). Of the 32 patients, 20 had a concomitant sports hernia repair in addition to an adductor longus tenotomy. Thirty-one patients (97%) were able to return to their previous sport, and 30 (94%) were able to return at their previous level of play. Thirty patients (94%) reported that they were satisfied with their decision to have surgery. No player complained of weakness or a decrease in running speed or power. Mean return to play was 12 weeks from date of surgery. In the subgroup analysis of 16 NFL players, there were no statistically significant differences for the pre- versus postoperative comparisons of the athlete performance scores ( P = .74) and the percentage of the games started versus played ( P = .46). After separation of players who had a concomitant hernia repair from players who did not, there was no statistically significant difference in performance scores or percentages of games started. Conclusion: In this study of elite athletes, adductor longus tenotomy with or without a concomitant sports hernia repair provided overall acceptable and excellent results. Athletes were able to return to their previous level of athletic competition and performance with consistent relief of groin pain. Return to play in an NFL game averaged 12 weeks following surgery.
机译：背景：龙渴肌腱的慢性菌株和/或肌腱病变是精英运动员中长期腹股沟疼痛的原因，导致竞争中失去了很大的时间。准确的诊断和治疗可以加快返回玩。目的/假设：在国家大学运动协会（NCAA）司对体育和绩效的返回体育和绩效追溯到有或没有运动疝修复的情况下，术语主席运动员和国家足球联赛（NFL）球员。我们假设收集器释放将是在这些运动员中顽固的腹股沟/接合剂疼痛治疗的有效处理方法。研究设计：案例系列;证据水平，4.方法：对所有NFL球员和NCAA司进行的队列研究，我的大学运动员进行了一名综合性疝气修复的有或没有体育疝修理的综合症，并在1999年5月之间获得了1个2013年1月。所有患者报告了腹股沟韧带低于腹股沟疼痛，并局限于其内膜龙头。症状持续超过10周，并限制运动能力在运动期间有效地表演，按照他们的教练和自我评估评估。给予所有26名患者的问卷，以评估长期手术结果。对NFL播放器进行了亚组分析，其中“性能分数”是根据个体播放器统计计算的。与手术后的慢性联合血管病变或菌株进行诊断之前获得的分数。患有现有腹部或骨盆手术的患者，髋关节的退行性关节疾病的放射照相证据，患有患者的患者或股骨髋臼，前列腺或泌尿道疾病，或神经夹杂物的髂骨，遗传物质或疏远股骨皮肤紧迫被排除在研究之外。结果：共有32名运动员在研究期间接受过牧羊人纵突。在这些患者中，28名是高校或专业级别的运动员，他们接受了一个牧羊犬腱鞘，其平均值±SD随访时间为6.2±4.2岁（范围，12-178个月）。在32例患者中，除了一个伴者龙族腱鞘外，还有20名患者伴随着体育疝修复。三十一名患者（97％）能够返回以前的运动，30（94％）能够以前的比赛返回。 30名患者（94％）报告说，他们对他们的决定感到满意，他们的手术。没有球员抱怨弱点或运行速度或力量的减少。意味着从手术之日起12周回归。在16个NFL球员的亚组分析中，与运动员性能分数的比较没有统计学上的显着差异（P = .74），比赛的百分比开始与播放（p = .46）。分离伴随着没有的球员伴随着疝气修复的球员，绩效评分没有统计学上显着差异或开始的游戏百分比。结论：在这项精英运动员的研究中，有或没有伴随体育疝修复的牧羊犬腱鞘，提供了整体可接受和优异的结果。运动员能够恢复他们以前的运动竞争和表现，并巩固腹股沟疼痛。在手术后12周的NFL游戏中返回游戏。

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