Bilateral mini-invasive adductor tenotomy for the management of chronic unilateral adductor longus tendinopathy in athletes.
BACKGROUND
To date, the best management of chronic groin pain related to adductor longus tendinopathy has not been defined. Although there have been some studies investigating the effectiveness of adductor longus tenotomy, none have investigated bilateral adductor tenotomy for unilateral tendinopathy.


OBJECTIVE
The use of bilateral percutaneous adductor tenotomy for the management of chronic unilateral groin pain as a result of adductor longus tendinopathy will result in improvement of overall function and facilitate a return to athletic activity.


METHODS
Case series; Level of evidence, 4.


METHODS
During the period from 2004 to 2007, we prospectively enrolled 29 consecutive athletes (26 male and 3 female; median age, 28 years) with chronic groin pain from unilateral adductor longus tendinopathy who underwent bilateral adductor tenotomy. Functional outcome and health status were assessed with the Hip Disability and Osteoarthritis Outcome Score (HOOS), Short Form Health Survey (SF-36), and European Quality of Life-5 Dimensions scale (EQ-5D). The ability to participate in sport before and after surgery and the time to return to training and return to sport were also recorded. The median follow-up after surgery was 36 months.


RESULTS
All questionnaires showed a statistically significant improvement (P < .0001) after surgery. At the time of latest follow-up, 20 of 29 patients (69%) returned to their preinjury level of sport and 2 of 29 patients (7%) to higher levels compared with preinjury status. However, 4 of 29 patients (14%) returned to sport at lower levels than those of preinjury status, and 3 of 29 patients (10%) ceased to participate in sport. The median time to return to training was 11 weeks and to return to sport was 18 weeks.


CONCLUSIONS
Bilateral mini-invasive adductor tenotomy can be an effective treatment for athletes suffering from unilateral chronic groin pain associated with adductor longus tendinopathy refractory to nonoperative management.
Orth Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London E1 4DG, United Kingdom. n.maffulli@qmul.ac.uk
Nicola
N
Maffulli
Mattia
M
Loppini
Umile Giuseppe
UG
Longo
Vincenzo
V
Denaro
D000328:Adult; D001265:Athletic Injuries / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006119:Groin / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010146:Pain / Q000601:surgery; D052256:Tendinopathy / Q000601:surgery*; D058971:Tenotomy; D055815:Young Adult