Research background: Athletic Pubalgia is a common, debilitating sports condition encountered by athletes who participate in competitive sports requiring pivoting movements. Athletic Pubalgia is often multifactorial w...Research background: Athletic Pubalgia is a common, debilitating sports condition encountered by athletes who participate in competitive sports requiring pivoting movements. Athletic Pubalgia is often multifactorial with several pathologies overlapping to cause groin pain. Soft tissue disruptions at the insertions of adductor longus and rectus abdominis to the pubic symphysis are often encountered. Prolotherapy is the method of injecting an irritant solution into a joint space, ligament or tendon insertion site. The solution is thought to induce a regenerative response in the affected area through several mechanisms, including the induction of inflammation and vascular reconfiguration. Research objectives: The use of prolotherapy to treat Athletic Pubalgia has not been reported. The aim of this study was to assess ultrasound-guided prolotherapy as a therapeutic option in the treatment of Athletic Pubalgia. Methods: A case report, with informed consent (human material or human data were performed in accordance with the Declaration of Helsinki), involving a 24-year-old female presenting with Athletic Pubalgia. The patient presented with severe chronic right groin pain sustained while playing camogie. Conservative management options, including rest and rehabilitation with physiotherapy had failed to control this pain. Through dynamic ultrasound scanning, focal lesions were identified in the insertions of rectus abdominis and adductor longus to the pubic symphysis. Prolotherapy with 5% dextrose to the affected areas was performed. Assessment of analgesic and rehabilitation response was planned. Results: A sustained analgesic effect was observed at clinical follow-up at 6 weeks. Patient returned to full sporting activity. Conclusions: Ultrasound-guided prolotherapy has not yet been described as a treatment option in Athletic Pubalgia. In this case report, it was an effective pain-relieving therapy with improved rehabilitation. Larger studies are required to evaluate its efficacy.展开更多
AIM: To investigate the association between sports hernias and femoroacetabular impingement(FAI) in athletes.METHODS: Pub Med, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases...AIM: To investigate the association between sports hernias and femoroacetabular impingement(FAI) in athletes.METHODS: Pub Med, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism.RESULTS: FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone(89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries.CONCLUSION: The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy.展开更多
文摘Research background: Athletic Pubalgia is a common, debilitating sports condition encountered by athletes who participate in competitive sports requiring pivoting movements. Athletic Pubalgia is often multifactorial with several pathologies overlapping to cause groin pain. Soft tissue disruptions at the insertions of adductor longus and rectus abdominis to the pubic symphysis are often encountered. Prolotherapy is the method of injecting an irritant solution into a joint space, ligament or tendon insertion site. The solution is thought to induce a regenerative response in the affected area through several mechanisms, including the induction of inflammation and vascular reconfiguration. Research objectives: The use of prolotherapy to treat Athletic Pubalgia has not been reported. The aim of this study was to assess ultrasound-guided prolotherapy as a therapeutic option in the treatment of Athletic Pubalgia. Methods: A case report, with informed consent (human material or human data were performed in accordance with the Declaration of Helsinki), involving a 24-year-old female presenting with Athletic Pubalgia. The patient presented with severe chronic right groin pain sustained while playing camogie. Conservative management options, including rest and rehabilitation with physiotherapy had failed to control this pain. Through dynamic ultrasound scanning, focal lesions were identified in the insertions of rectus abdominis and adductor longus to the pubic symphysis. Prolotherapy with 5% dextrose to the affected areas was performed. Assessment of analgesic and rehabilitation response was planned. Results: A sustained analgesic effect was observed at clinical follow-up at 6 weeks. Patient returned to full sporting activity. Conclusions: Ultrasound-guided prolotherapy has not yet been described as a treatment option in Athletic Pubalgia. In this case report, it was an effective pain-relieving therapy with improved rehabilitation. Larger studies are required to evaluate its efficacy.
文摘AIM: To investigate the association between sports hernias and femoroacetabular impingement(FAI) in athletes.METHODS: Pub Med, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism.RESULTS: FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone(89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries.CONCLUSION: The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy.
