It's Athletic Pubalgia Hip Preservation Section Dec 8 th , 2017 - PowerPoint PPT Presentation

It's Athletic Pubalgia Hip Preservation Section Dec 8 th , 2017 Srino Bharam, MD Clinical Professor Mount Sinai School of Medicine Director, Hip Arthroscopy Lenox Hill Hospital New York, NY

I (and/or my co-authors) have something to disclose. Detailed disclosure information is available via: AAOS Orthopaedic Disclosure Program on the AAOS website at http://www.aaos.org/disclosure

Above Symphysis At Level of Symphysis Inguinal disruption Pubic rami stress fracture Rectus abdom injuries Adductor avulsion Ilioinguinal nerve entrapment Adductor enthesopathy Below Symphysis Adductor musculotendinous injuries Adductor strain Obturator n entrapment

I II III

66% of groin injuries 91% US, 93% MRI Majority involve adductor longus Serner et al AJSM 2015

Total 557 European professional players 2001-2010 seasons Incidence = 0.72; p = .98 Walden et al Scand J Med Sci Sports 2011

Disruption of complex Displacement of pyramidalis and proximal adductor

Pubic symphysis Prox adductor insertion Rectus insertion/border Inguinal canal Dilated superficial ring

Dedicated MRI pelvis Axial oblique Saggittal Schilders JBJS 2009

Thigh ecchymosis Medial and posterior Antalgic gait Weak resisted Adduction in extension and flexion

Srino Bharam MD, Daniel Feghhi MD, David A Porter MD

Number of Series Cases Age Sex Retraction Outcomes Anchors mHHS, HOS, Bharam et. 6 39 M 3.2 2.8 cm VAS, Patient al, in prep Satisfaction Rizio et. al, 2 27.5 M 2 No report No report 2004 Vogt et. al, 1 43 M 2 3 cm No report 2004 Dimitrakopo ulou et. al, 2 25.5 M 6.5 4 cm No report 2008 Schlegel et. 5 27.2 M Not listed 2.4 cm No report al, 2009

Groin injuries can occur in absence of FAI symptoms Predominantly male athletes Comprehensive History and Exam!