title: Nonoperative treatment and return to play after complete proximal adductor avulsion in high-performance athletes.
abstract: OBJECTIVE
  To assess the outcome of nonoperative treatment after complete avulsion of the proximal adductor longus tendon in high-performance athletes.
  
  
  METHODS
  Six consecutive athletes were included. Treatment was conservative following a strict rehabilitation plan. Following parameters were analysed: basic data, mechanism of injury, classification, tendon retraction, size of defect in MRI and return to play (RTP).
  
  
  RESULTS
  Mean age at injury was 28 ± 5 (range 20-32) years. Overstretch (83 %) and kicking (50 %) were the most frequent injury mechanisms, and the dominant leg was involved in 83 %. Average retraction of the avulsed tendon amounted 21 ± 5 mm. Follow-up MRIs demonstrated a gradual reattachment of the tendon in all cases. All athletes returned to full sportive activity on preinjury level within 88.7 ± 12.8 (range 75-110) days with no functional deficiencies. Manual muscle strength was equal to the contralateral side.
  
  
  CONCLUSIONS
  Nonoperative treatment with a healing phase and a strict rehabilitation plan results in a functional, efficient reattachment of the tendon and allows unrestricted RTP. Since these injuries are rare, present study may help sports physicians when dealing with this type of injuries in professional athletes. Return to sports can be expected at approximately 13 weeks after injury, but can take even longer.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: MW Center of Orthopedics and Sports Medicine, Dienerstrasse 12, 80331, Munich, Germany. peter.ueblacker@gmx.net.|Football Club FC Bayern, Munich, Germany. peter.ueblacker@gmx.net.
authors.forename: Peter
authors.initials: P
authors.lastname: Ueblacker
authors.affiliation: Middlesbrough Football Club, Middlesbrough, England, UK.
authors.forename: Bryan
authors.initials: B
authors.lastname: English
authors.affiliation: MW Center of Orthopedics and Sports Medicine, Dienerstrasse 12, 80331, Munich, Germany.|Football Club FC Bayern, Munich, Germany.
authors.forename: Hans-Wilhelm
authors.initials: HW
authors.lastname: Mueller-Wohlfahrt
mesh_terms: D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D054874:Athletic Performance; D006801:Humans; D007869:Leg Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D008279:Magnetic Resonance Imaging; D008297:Male; D053580:Muscle Strength; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D000068958:Return to Sport; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D013848:Thigh; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: Adductor longus; Avulsion; Football; Muscle injury; Professional athletes; Tendon