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Athletic 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
David Segal, Iris Eshed, Niv Marom, Georgiy Gurman, Jacopo Chen, Meir Nyska, Gideon Mann, Eyal Yaacobi
INTRODUCTION: Infectious osteomyelitis of the symphysis pubis, known as pubic osteomyelitis is a rare condition with potentially devastating consequences. To the best of our knowledge, this article is the first reported case of a military trainee presenting with pubic osteomyelitis. MATERIALS AND METHODS: We present a unique case of a patient who simultaneously suffered a combination of local recurrent stress to the symphysis pubis area, and slow-healing multiple palm and finger lacerations which probably acted as distant ports of bacterial entry that concomitantly led to his illness...
March 2017: Military Medicine
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
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
A Larbi, L Pesquer, G Reboul, P Omoumi, A Perozziello, P Abadie, P Loriaut, P Copin, E Ducouret, B Dallaudière
BACKGROUND: Recent studies described that MRI is a good examination to assess damage in chronic athletic pubalgia (AP). However, to our knowledge, no studies focus on systematic correlation of precise tendon or parietal lesion in MRI with surgery and histological assessment. Therefore, we performed a case-control study to determine if MRI can precisely assess Adductor longus (AL) tendinopathy and parietal lesion, compared with surgery and histology. HYPOTHESIS: MRI can determine if AP comes from pubis symphysis, musculotendinous or inguinal orifice structures...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Steven M Short, Philip A Anloague, Donald S Strack
Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game...
August 2016: Journal of Orthopaedic and Sports Physical Therapy
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
R J Tansey, H Benjamin-Laing, S Jassim, K Liekens, A Shankar, F S Haddad
Hip and groin injuries are common in athletes who take part in high level sports. Adductor muscle tendon injuries represent a small but important number of these injuries. Avulsion of the tendons attached to the symphysis pubis has previously been described: these can be managed both operatively and non-operatively. We describe an uncommon variant of this injury, namely complete avulsion of the adductor sleeve complex: this includes adductor longus, pectineus and rectus abdominis. We go on to describe a surgical technique which promotes a full return to the pre-injury level of sporting activity...
November 2015: Bone & Joint Journal
Randy M Cohn, Frantz Lerebours, Eric J Strauss
Groin pain is a common complaint in athletes that use the musculature of the lower abdomen and proximal thigh. The complex anatomy of the groin region and broad differential diagnosis presents the sports medicine specialist with unique diagnostic and treatment challenges. Sports hernia, osteitis pubis, and adductor dysfunction are common extra-articular musculoskeletal causes of groin pain in athletes. The current paper reviews the pathogenesis, history and physical examination, imaging, non-operative treatment, surgical techniques, and outcomes for these conditions...
June 2015: Bulletin of the Hospital for Joint Diseases
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
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
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
Matthew Crockett, Emily Aherne, Michael O'Reilly, Gavin Sugrue, James Cashman, Eoin Kavanagh
INTRODUCTION: Groin pain is a common symptom in athletes, particularly in sports requiring sudden changes in speed and direction and those involving kicking. Despite a high prevalence of groin pain in this patient cohort, the diagnosis and management of the underlying pathological processes remains a challenge for surgeons and radiologists alike. AIM: The aim of this paper is to review the imaging findings and management of the common pathological processes which produce groin pain in athletes...
May 2015: Surgical Technology International
Matthieu Sailly, Rod Whiteley, John W Read, Bruno Giuffre, Amanda Johnson, Per Hölmich
BACKGROUND: Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneath the insertions of symphysial joint capsule and adductor longus tendon. Little is known about this apophysis and its response to chronic stress. AIM: We report pubic apophysitis as a clinically relevant entity in adolescent athletes...
June 2015: British Journal of Sports Medicine
Rohit Rambani, Roger Hackney
BACKGROUND: sports hernia is a well-recognized cause of groin pain in athletes involved in sports, especially football and rugby. Loss of range of motion of the hip joint is a possible contributory factor to stress across the symphysis pubis leading to the instability. METHODS: twenty-five athletes presenting with sports hernia were matched to age, sex, physical/sports activity and co-morbidities with twenty-five athletes without sports hernia. The range of movement of both the hips was compared in athletes of both the groups...
January 2015: Muscles, Ligaments and Tendons Journal
Dean K Matsuda, Manel Ribas, Nicole A Matsuda, Benjamin G Domb
PURPOSE: To investigate outcomes of athletic patients treated with concurrent femoroacetabular impingement (FAI) and osteitis pubis (OP) surgery including endoscopic pubic symphysectomy. METHODS: We performed a multicenter retrospective case series of 7 consecutive adult patients (4 men) with a mean age of 33 years with symptomatic FAI and OP who underwent arthroscopic surgery for the former and endoscopic pubic symphysectomy for the latter with a mean follow-up period of 2...
July 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
L Pesquer, G Reboul, A Silvestre, N Poussange, P Meyer, B Dallaudière
Groin pain is a common condition in athletes and results from various causes. Osteitis pubis, adductor dysfunction, inguinal hernia, or a combination of all three entities, generally explains the onset of symptoms. Adductor longus tendinopathy is the main cause of adductor-related groin pain. It leads to a significant reduction of sports participation and can require surgical management. Diagnosis is based on ultrasonography and magnetic resonance imaging. Asymptomatic findings (tendinosis, calcifications, cortical erosions) are common in athletes and care should be taken when assessing groin pain...
September 2015: Diagnostic and Interventional Imaging
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