The management of sportsman's groin hernia in professional and amateur soccer players: a revised concept.
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.


OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
Selective surgical hernia repair, based on meticulous anamnesis and physical examination is effective in the management of chronic groin pain in athletes.
Department of Surgery B, HaEmek Medical Center, Afula, Israel. kopelmand@bezeqint.net.|Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. kopelmand@bezeqint.net.|Maccabi Haifa Football Club, Sports Medicine Center, Haifa, Israel. kopelmand@bezeqint.net.
D
D
Kopelman
Department of Surgery B, HaEmek Medical Center, Afula, Israel.
U
U
Kaplan
Department of Surgery B, HaEmek Medical Center, Afula, Israel.|Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
O A
OA
Hatoum
Department of Surgery B, HaEmek Medical Center, Afula, Israel.
N
N
Abaya
Department of Surgery B, HaEmek Medical Center, Afula, Israel.
D
D
Karni
Maccabi Haifa Football Club, Sports Medicine Center, Haifa, Israel.
A
A
Berber
Maccabi Haifa Football Club, Sports Medicine Center, Haifa, Israel.
P
P
Sharon
Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.|Maccabi Haifa Football Club, Sports Medicine Center, Haifa, Israel.|Knee and Arthroscopy Unit, Orthopedic Division, Rambam Medical Center, Haifa, Israel.
B
B
Peskin
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000601:surgery*; D059350:Chronic Pain / Q000209:etiology / Q000601:surgery*; D006119:Groin / Q000601:surgery; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012916:Soccer / Q000293:injuries; D055815:Young Adult
Groin pain in athletes; Sportsman’s hernia