25.0: Thursday, March 17, 2005

Treatment of Athletic Pubalgia: Retrospective Review at a University Hospital

Leonik Ahumada, MD, Jorge I de la Torre, and Luis O Vasconez.

Purpose:Review of patients with athletic pubalgia. A condition afflicting high performance sports athletes. It can occur in everyday people. Presentation with localized inguinal pain exacerbated with physical activity. Examination reveals point tenderness, exacerbated by resisted adduction of hip without hernia. Treatment by open Bassini type repair, reinforced with mesh alleviates symptoms. Methods: Retrospective review patients with athletic pubalgia underwent operative therapy December 1999 to November 2004. Data reviewed for age, gender, laterality, sport, time to presentation, follow-up, outcome, and anatomy. Results: Eleven patients, median age 25 years (17-65). Activities equally between soccer, running, basketball and football. Average time to presentation 9 months. Two bilateral, 4 right, and 5 left- sided. One re-operation. Majority of findings had attenuated external oblique and inguinal floor and lipoma of cord. All underwent open inguinal, polypropylene mesh repair approximation of conjoined area to inguinal ligament(Bassini). Three had adductor tenotomy. Median follow-up 122 days (90-702), 80% excellent and 20% satisfactory results. 100% returned to sports. Discussion: Diagnosis of athletic pubalgia can be elusive. Patients are treated non-operatively without an obvious hernia. Diagnostic studies are non-confirmatory. It can be found in everyday people. An open approach using mesh, a technique available to plastic surgeons, relieves the pain.