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Groin pain

M P Charalambous, C P Charalambous
PURPOSE: Chronic post-operative groin pain is a substantial complication following open mesh inguinal hernia repair. The exact cause of this pain is still unclear, but entrapment or trauma of the ilioinguinal nerve may have a role to play. Elective division of this nerve during hernia repair has been proposed in an attempt to reduce the incidence of chronic groin pain. METHODS: We performed a meta-analysis of nine randomized controlled trials comparing preservation versus elective division of the ilioinguinal nerve during this operation...
March 17, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Enda King, Andrew Franklyn-Miller, Chris Richter, Eamon O'Reilly, Mark Doolan, Kieran Moran, Siobhan Strike, Éanna Falvey
BACKGROUND: Clinical assessments and rehabilitation in athletic groin pain (AGP) have focused on specific anatomical structures and uniplanar impairments rather than whole body movement. OBJECTIVE: To examine the effectiveness of rehabilitation that targeted intersegmental control in patients with AGP and to investigate post rehabilitation changes in cutting biomechanics. METHODS: Two hundred and five patients with AGP were rehabilitated focusing on clinical assessment of intersegmental control, linear running and change of direction mechanics in this prospective case series...
March 17, 2018: British Journal of Sports Medicine
Andrea B Mosler, Rintje Agricola, Kristian Thorborg, Adam Weir, Rod J Whiteley, Kay M Crossley, Per Hӧlmich
Study Design Cross-sectional cohort study. Background Athletes with femoroacetabular impingement (FAI) syndrome have cam and/or pincer morphology, pain on orthopaedic testing, and often have reduced hip range of motion (ROM) and strength. However, cam and pincer morphology are also common in asymptomatic hips. Therefore, it is currently unknown whether the ROM and strength deficits observed in athletes with FAI syndrome result from the variance in their bony hip morphology or hip condition. Objectives To investigate the relationship between musculoskeletal screening findings and bony hip morphology in asymptomatic male soccer players...
March 16, 2018: Journal of Orthopaedic and Sports Physical Therapy
C Keller, B Mück
We report on an endoscopic triple neurectomy in a female patient with vulvar carcinoma metastasized to the left groin with refractory neuropathic inguinodynia. Using a retroperitoneoscopic approach we resected the ilioinguinal, iliohypogastric, and genitofemoral nerves. The inguinodynia improved significantly; especially the reduced ability to walk was enhanced considerably. Endoscopic triple neurectomy could be a useful therapeutic option in refractory inguinal pain caused by local tumor manifestation.
March 14, 2018: Der Schmerz
Joshua J Heerey, Joanne L Kemp, Andrea B Mosler, Denise M Jones, Tania Pizzari, Richard B Souza, Kay M Crossley
BACKGROUND: Intra-articular hip pathologies are thought to be associated with the development of hip and groin pain. A better understanding of the relationship between symptoms and imaging findings may improve the management of individuals with intra-articular hip pathologies. OBJECTIVE: To undertake a systematic review and meta-analysis to determine the prevalence of intra-articular hip pathologies in individuals with and without pain. METHODS: Seven electronic databases were searched in February 2017 for studies investigating the prevalence of intra-articular hip pathologies using MRI, MRA or CT...
March 14, 2018: British Journal of Sports Medicine
Miriam Elisabeth Uhlmann, Corinna Walter, Fadi Taher, Markus Plimon, Jürgen Falkensammer, Afshin Assadian
OBJECTIVE: Because of its minimally invasive nature, percutaneous femoral access for endovascular aneurysm repair (pEVAR) is currently undergoing rapid popularization. Compared with surgical cutdown for femoral access (cEVAR), it offers the advantage of faster recovery after surgery as well as a reduction in wound complications. Despite proposed advantages, the method is largely considered uneconomical because of its reliance on costly closure devices. METHODS: There were 50 patients undergoing EVAR who were enrolled in this randomized prospective single-center trial...
March 8, 2018: Journal of Vascular Surgery
Kristoffer Andresen
Inguinal hernias are a protrusion of the peritoneum through a weakening in the groin in which abdominal content (intestines or fat) can herniate and cause a bulge. Inguinal hernias can be painful and require surgery. Worldwide, approximately 20 million patients are operated each year, with 10,000 in Denmark. The repair of inguinal hernias causes pain and 16% of patients experience chronic pain six months after the standard, open, mesh-based Lichtenstein technique. Therefore, surgeons are trying to improve the techniques by finding new ways of operating...
March 2018: Danish Medical Journal
Kristian Thorborg, Michael P Reiman, Adam Weir, Joanne L Kemp, Andreas Serner, Andrea Mosler, Per Hölmich
Study Design Groin pain is common in athletes participating in multidirectional sports and has traditionally been considered a difficult problem to understand, diagnose, and manage. This may be due to sparse historical focus on this complex region in sports medicine. Until recently, there was no agreement regarding terminology, definitions, and classification of groin pain in athletes. This has made clear communication between clinicians difficult, and the results of research difficult to interpret and implement into practice...
March 6, 2018: Journal of Orthopaedic and Sports Physical Therapy
Michael T Froehler, Rohan Chitale, Jordan A Magarik, Matthew R Fusco
PURPOSE: The efficiency of neuroendovascular procedures may partly depend on the time devoted to placement of a radial arterial line (RAL) for intraoperative blood pressure monitoring. An alternative approach is to use a pressure-sensing sheath (PSS) that serves to provide invasive blood pressure monitoring without requiring a separate procedure for placement. We compared the use of a RAL versus PSS and assessed procedure time, anesthetist and patient satisfaction, and cost. METHODS: We performed a single-center, prospective, blockwise, comparative trial of procedure start time using traditional RAL placement versus the EndoPhys PSS for invasive blood pressure monitoring...
February 27, 2018: Journal of Neurointerventional Surgery
Juliet J Ray, Sarah A Eidelson, Charles A Karcutskie, Jonathan P Meizoso, Hilene DeAmorim, Lee J Goldstein, John Karwowski, Arash Bornak
INTRODUCTION: This study examines the outcome of hybrid revascularization combining iliofemoral endartectomy and iliac artery stenting using covered stents in TASC C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS: A retrospective review was conducted of patients with TASC C and D AIOD involving the CFA and undergoing hybrid revascularization. Covered stents were used primarily. Demographics, indications for surgery, lesion classification, hospital length-of-stay (LOS), 30-day morbidity/mortality, hemodynamic and clinical success, as well as patency were assessed...
February 23, 2018: Annals of Vascular Surgery
Christopher J Sardon, Mathew L Resnick
BACKGROUND: Acetabular labral tears in the hip have become an increasingly common finding in active duty members due to improved diagnostic capabilities. This has led to a dramatic increase in operative management despite a lack of evidence to support clear long-term benefits. Literature review demonstrated overwhelmingly positive short-term outcomes for labral repairs; however, scattered case reports exist demonstrating debilitating outcomes in young patients, ultimately resulting in total hip arthroplasty...
February 1, 2018: Aerospace Medicine and Human Performance
William Kromka, Aline S Rau, Charles J Fox
INTRODUCTION: An Amyand's hernia is a heterogeneous clinical condition defined by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not contain other abdominal contents or pathologic inflammatory changes. Herein we present an exceptionally rare case of an Amyand's hernia containing acute appendicitis and a perforated cecum. PRESENTATION OF CASE: A 46-year-old male with a right inguinal hernia of 2-3 year duration presented to our Emergency Department complaining of acute onset abdominal and groin pain...
February 14, 2018: International Journal of Surgery Case Reports
James G Bittner Iv, Lawrence W Cesnik, Thomas Kirwan, Laurie Wolf, Dongjing Guo
Few publications describe the potential benefit of robotic-assisted inguinal hernia repair on acute postoperative groin pain (APGP). This study compared patients' perceptions of APGP, activity limitation, and overall satisfaction after robotic-assisted- (R), laparoscopic (L), or open (O) inguinal hernia repair (IHR). Random samples of patients from two web-based research panels and surgical practices were screened for patients who underwent IHR between October 28, 2015 and November 1, 2016. Qualified patients were surveyed to assess perceived APGP at 1 week postoperatively, activity disruption, and overall satisfaction...
February 16, 2018: Journal of Robotic Surgery
Igor Tak, David Pope, Leonie Engelaar, Vincent Gouttebarge, Maarten Barendrecht, Sylvia Van den Heuvel, Gino Kerkhoffs, Rob Langhout, Janine Stubbe, Adam Weir
No abstract text is available yet for this article.
February 15, 2018: British Journal of Sports Medicine
Billy Sin, John Cao, David Yang, Karen Ambert, Sheena Punnapuzha
CLINICAL FEATURES: Renal colic is defined as a flank pain radiating to the groin caused by kidney stones in the ureter (urolithiasis). Renal colic is a frequent cause of Emergency Department visits. Most renal colic cases present as acute distress and severe back and/or abdominal pain that require prompt treatment with analgesics. THERAPEUTIC CHALLENGE: Nonsteroidal anti-inflammatory drugs and opioids are traditionally used for renal colic in the Emergency Department...
February 13, 2018: American Journal of Therapeutics
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
Ludwig Oberkircher, Steffen Ruchholtz, Pol Maria Rommens, Alexander Hofmann, Benjamin Bücking, Antonio Krüger
BACKGROUND: The estimated incidence of osteoporotic pelvic fractures among persons over age 60 in Germany is 224 per 100 000 persons per year, and rising. A number of surgical treatment options are available, but clinical long-term data are lacking. METHODS: This review is based on pertinent publications and guidelines retrieved by a selective literature search, and on the authors' clinical experience. RESULTS: Patients often report one or more relatively trivial traumatic incidents leading up to the fracture...
February 2, 2018: Deutsches Ärzteblatt International
S Gore, A Franklyn-Miller, C Richter, E C Falvey, E King, K Moran
Athletic groin pain (AGP) is a common injury prevalent in field sports. One biomechanical measure that may be of importance for injury risk is stiffness. To date however, stiffness has not been examined in AGP. The primary aim was to determine if AGP affects vertical and joint stiffness and if so, whether successful rehabilitation is associated with a change in stiffness. Sixty-five male patients with AGP and fifty male controls were recruited to this study. Assessment included a biomechanical examination of stiffness during a lateral hurdle hop test...
February 9, 2018: Scandinavian Journal of Medicine & Science in Sports
Andrea M Spiker, Ben-Zion Rotter, Brenda Chang, Douglas N Mintz, Bryan T Kelly
Intra-articular osteoid osteoma (IAOO) of the hip is a relatively rare diagnosis, but one that can closely mimic symptomatic presentation of femoroacetabular impingement (FAI). Although there are multiple case reports of osteoid osteoma (OO) in the hip, we present the largest case series of hip IAOO treated with hip arthroscopy and discuss limited patient-reported outcomes after treatment with hip arthroscopy. We retrospectively identified patients diagnosed with IAOO of the hip with confirmatory computed tomography, magnetic resonance imaging or biopsy diagnoses of OO...
January 2018: Journal of Hip Preservation Surgery
Julie Sandell Jacobsen, Per Hölmich, Kristian Thorborg, Lars Bolvig, Stig Storgaard Jakobsen, Kjeld Søballe, Inger Mechlenburg
The primary aim was to identify muscle-tendon-related pain in 100 patients with hip dysplasia. The secondary aim was to test whether muscle-tendon-related pain is associated with self-reported hip disability and muscle strength in patient with hip dysplasia. One hundred patients (17 men) with a mean age of 29 years (SD 9) were included. Clinical entity approach was carried out to identify muscle-tendon-related pain. Associations between muscle-tendon-related pain and self-reported hip disability and muscle strength were tested with multiple regression analysis, including adjustments for age and gender...
January 2018: Journal of Hip Preservation Surgery
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