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Osteitis Pubis

Dean K Matsuda, Nicole A Matsuda, Rachel Head, Tanya Tivorsak
Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia...
February 2017: Arthroscopy Techniques
A Kanthabalan, M Peters, M Van Vulpen, N McCartan, R G Hindley, A Emara, M C Moore, M Arya, M Emberton, H U Ahmed
OBJECTIVE: To assess short to medium term cancer control rates and side effects of focal salvage High Intensity Focused Ultrasound (HIFU). MATERIALS AND METHODS: A retrospective registry analysis identified 150 men who underwent focal salvage HIFU (Sonablate 500) (November 2006-August 2015). Metastatic disease was excluded using the nodal assessment on the pelvic MRI, a radioisotope bone scan and PET imaging (choline-FDG-PET or Choline PET-CT). In our current clinical practice, metastatic disease must be ruled out by both Choline PET and bone scan...
March 4, 2017: BJU International
T Sean Lynch, Asheesh Bedi, Christopher M Larson
Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
Iclal Erdem Toslak, Bulent Cekic, Aysen Turk, Ali Eraslan, A Eda Parlak
PURPOSE: Our aims were to determine the feasibility of diffusion-weighted magnetic resonance imaging (DWI) in the detection of bone marrow edema (BME) and explore the apparent diffusion coefficient (ADC) alterations in patients with osteitis pubis (OP). MATERIALS AND METHODS: Fourty two consecutive patients clinically suspected to have athletic pubalgia and 31 control subjects were enrolled in the study. All subjects underwent diagnostic focused magnetic resonance imaging (MRI) and DWI at b values of 0 and 600 s/mm(2)...
February 13, 2017: Magnetic Resonance in Medical Sciences: MRMS
M Schöberl, L Prantl, O Loose, J Zellner, P Angele, F Zeman, M Spreitzer, M Nerlich, W Krutsch
PURPOSE: The incidence of groin pain in athletes is steadily increasing. Symptomatic pubic overload with groin pain and aseptic osteitis pubis represent well-known and frequently misdiagnosed overuse injuries in athletes. This study investigated the benefits of standardised non-surgical treatment for swift return-to-football. METHODS: In a prospective double-blinded controlled study, 143 amateur football players with groin pain as well as radiological signs and clinical symptoms of pubic overload were analysed for 1 year...
January 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthew J Kraeutler, Tigran Garabekyan, Omer Mei-Dan
BACKGROUND: In recent years, platelet-rich plasma (PRP) has gained popularity within the orthopaedic community as a treatment modality to enhance tissue healing. PURPOSE: This review aims to concisely present the current indications for PRP injections in the treatment of hip and pelvic pathologies and to describe some novel applications for PRP which have not yet been reported in the literature. METHODS: We reviewed the literature on the non-operative and operative indications for PRP in the treatment of hip and pelvic pathologies...
July 2016: Muscles, Ligaments and Tendons Journal
F Fridrich, V Báča, V Džupa
Purulent inflammation of the pubic symphysis is a rare condition involving the symphysis and parasymphyseal parts of the pubic bones. It is usually found in immuno-compromised patients and its most frequent cause is Staphylococcus aureus. Conservative treatment is based on long-term administration of antibiotics and has been efficient, as reported, in about 50% of the patients. The authors treated five patients with a late diagnosis of purulent infection of the pubic symphysis in whom the antibiotic therapy had to be completed by surgical intervention...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Scott W Cheatham, Morey J Kolber, Kathryn Kumagai Shimamura
Clinical Scenario: The differential diagnosis of groin pain can be very challenging due to the many causative pathologies. Osteitis pubis is a pathology that is becoming more recognized in athletes who participate in sports such as soccer, ice hockey, rugby, and football. Conservative nonoperative treatment is often prescribed first before surgical intervention. Of particular interest are the outcomes of nonoperative rehabilitation programs and their effectiveness to return athletes to preinjury levels of participation...
December 2016: Journal of Sport Rehabilitation
Osama Elattar, Ho-Rim Choi, Vickie D Dills, Brian Busconi
CONTEXT: Groin pain is a common entity in athletes involved in sports that require acute cutting, pivoting, or kicking such as soccer and ice hockey. Athletic pubalgia is increasingly recognized as a common cause of chronic groin and adductor pain in athletes. It is considered an overuse injury predisposing to disruption of the rectus tendon insertion to the pubis and weakness of the posterior inguinal wall without a clinically detectable hernia. These patients often require surgical therapy after failure of nonoperative measures...
July 2016: Sports Health
Elizabeth Phillips, Viviane Khoury, Andrew Wilmot, John D Kelly
A mechanistic link has been suggested between cam-type femoroacetabular impingement and increased stress on the symphysis pubis. This retrospective study was conducted to determine whether there is an increased prevalence of osteitis pubis, as evidenced by imaging, in patients with femoroacetabular impingement compared with age-matched control subjects. Search of a radiologic database of a large academic health institution for all patients with cam-type femoroacetabular impingement diagnosed by magnetic resonance imaging or magnetic resonance arthrogram between January 2000 and October 2013 identified 46 cases...
May 1, 2016: Orthopedics
Louise Dickinson, Manit Arya, Naveed Afzal, Paul Cathcart, Susan C Charman, Andrew Cornaby, Richard G Hindley, Henry Lewi, Neil McCartan, Caroline M Moore, Senthil Nathan, Chris Ogden, Raj Persad, Jan van der Meulen, Shraddha Weir, Mark Emberton, Hashim U Ahmed
BACKGROUND: High-intensity focused ultrasound (HIFU) is a minimally-invasive treatment for nonmetastatic prostate cancer. OBJECTIVE: To report medium-term outcomes in men receiving primary whole-gland HIFU from a national multi-centre registry cohort. DESIGN, SETTING, AND PARTICIPANTS: Five-hundred and sixty-nine patients at eight hospitals were entered into an academic registry. INTERVENTION: Whole-gland HIFU (Sonablate 500) for primary nonmetastatic prostate cancer...
October 2016: European Urology
Pieter Jan Elshout, Pieter Verleyen, Guy Putzeys
TURP is a widespread urologic procedure that is performed by many urologists. This report describes a rare complication that causes serious morbidity because it is not recognized in time. This is also the first report of a prostatosymphyseal fistula treated without major surgery. Eventually diagnosis is made by a MRI 5 months after surgery. Decompressive surgery was necessary to treat pubic osteïtis with invalidating pain. Culture results revealed Escherichia coli but eventually the diagnosis was made by fistulography...
January 2016: Urology Case Reports
Philipp Pieroh, Nick Spindler, Stefan Langer, Christoph Josten, Jörg Böhme
BACKGROUND: Osteitis pubis or symphysitis pubis is a rare occurring non-infectious inflammation of the symphysis, the adjacent pubic bones and surrounding tissue. The therapy might be conservative or surgical by a resection of the symphysis and involved parts of the pubic bone. Nevertheless, this resection might lead to an anterior instability impairing the posterior arch and the sacroiliac joints in the aftermath. CASE PRESENTATION: Here, we report about a 50-year-old women suffering from osteitis pubis treated by wedge resection of the symphysis and parts of the pubic bone...
January 2016: Archives of Orthopaedic and Trauma Surgery
Antonios G Angoules
Osteitis pubis (OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to pubis sympysis instability as the result of microtrauma caused by repetitive muscle strains on pubic bones. Diagnosis is based mainly on detailed sports history and a meticulous clinical examination, although occasionally is difficult to distinguish this nosological entity from other pathologies affecting the involved area which may occur concomitantly in the same patient...
October 18, 2015: World Journal of Orthopedics
Parthasarthi Ramakrishnan, Saurabh Bansal, Biswajit Deuri, Rajapandian Subbiah, Senthilnathan Palanisamy, Praveen Raj Palanivelu, Palanivelu Chinusamy
BACKGROUND: Management of complications of laparoscopic inguinal hernia repair remains challenging as well as debatable. Relaparoscopy in management of these complications is relatively newer concept. We tried to analyse the feasibility of relaparoscopy (transabdominal preperitoneal approach) in management of complications of laparoscopic inguinal hernia repair. MATERIALS AND METHODS: The study group included 61 patients (referral cases) from a prospectively maintained database of previous laparoscopic inguinal hernia surgery with majority of the patients of recurrence (n = 39)...
June 2016: Surgical Endoscopy
Simon Bugeja, Daniela E Andrich, Anthony R Mundy
PURPOSE: Chronic pubic pain after the treatment of prostate cancer is often attributed to osteitis pubis. We have become aware of another complication, namely fistulation into the pubic symphysis, which is more serious and more common than previously thought. MATERIALS AND METHODS: A total of 16 patients were treated for urosymphyseal fistulas after the treatment of prostate cancer between January 2011 and April 2014. Clinical presentation was characterized by chronic, debilitating pubic/pelvic/groin pain in all patients...
February 2016: Journal of Urology
Dean K Matsuda, Bantoo Sehgal, Nicole A Matsuda
Osteitis pubis is a common form of athletic pubalgia associated with femoroacetabular impingement. Endoscopic pubic symphysectomy was developed as a less invasive option than open surgical curettage for recalcitrant osteitis pubis. This technical note demonstrates the use of the anterior and suprapubic portals in the supine lithotomy position for endoscopic burr resection of pubic symphyseal fibrocartilage and hyaline endplates. Key steps include use of the suprapubic portal for burr resection of the posteroinferior symphysis and preservation of the posterior and arcuate ligaments...
June 2015: Arthroscopy Techniques
Dana J Coker, Adam C Zoga
Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury...
August 2015: Topics in Magnetic Resonance Imaging: TMRI
Stephen S McAleer, Justus Gille, Stefan Bark, Helge Riepenhof
BACKGROUND/AIM: The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent chronic groin pain and evaluate the evidence of the interventions. METHODS: A professional footballer presented with chronic recurrent OP/PBS. The injury was managed successfully with a nine-point programme - 1. Acute pharmacological management. 2. Tone reduction of over-active structures. 3. Improved ROM at hips, pelvis and thorax...
August 2015: Physical Therapy in Sport
Scott Cheatham, Morey J Kolber, Kathryn Kumagai Shimamura
Clinical Scenario: The differential diagnosis of groin pain can be very challenging due to the many causative pathologies. Osteitis pubis is one pathology that is becoming more recognized in athletes who participate in sports such as soccer, ice hockey, rugby, and football.1 Conservative non-operative treatment is often prescribed first prior to surgical intervention. Of particular interest, are the outcomes of non-operative rehabilitation programs and their effectiveness to return athletes to pre-injury levels of participation...
June 10, 2015: Journal of Sport Rehabilitation
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