World J Clin Cases. 2015 Sep 16;3(9):823-30. doi: 10.12998/wjcc.v3.i9.823.
Sports hernia and femoroacetabular impingement in athletes: A systematic review.
World journal of clinical cases
Daniele Munegato, Marco Bigoni, Giulia Gridavilla, Stefano Olmi, Giovanni Cesana, Giovanni Zatti
Affiliations
Affiliations
- Daniele Munegato, Marco Bigoni, Giulia Gridavilla, Giovanni Zatti, Clinica Ortopedica AO San Gerardo, Università degli Studi di Milano Bicocca, 20900 Monza, Italy.
PMID: 26380829
PMCID: PMC4568531 DOI: 10.12998/wjcc.v3.i9.823
Abstract
AIM: To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes.
METHODS: PubMed, 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.
Keywords: Athletic pubalgia; Femoroacetabular impingement; Groin pain; Laparoscopic treatment; Sports hernia
References
- Am J Sports Med. 2009 Nov;37(11):2140-3 - PubMed
- Br J Sports Med. 1995 Sep;29(3):206-8 - PubMed
- Br J Surg. 2000 May;87(5):545-52 - PubMed
- Knee Surg Sports Traumatol Arthrosc. 2014 Apr;22(4):786-92 - PubMed
- Curr Sports Med Rep. 2007 Apr;6(2):111-4 - PubMed
- J Sci Med Sport. 2014 Mar;17(2):155-9 - PubMed
- Ann Surg. 2008 Oct;248(4):656-65 - PubMed
- Am J Sports Med. 2012 May;40(5):1113-8 - PubMed
- Hernia. 2003 Jun;7(2):68-71 - PubMed
- Surg Endosc. 2006 Jun;20(6):971-3 - PubMed
- Orthopedics. 2010 Mar;33(3):null - PubMed
- J Sci Med Sport. 2005 Mar;8(1):77-84 - PubMed
- Orthopedics. 2012 Sep;35(9):e1371-5 - PubMed
- Aust N Z J Surg. 1992 Feb;62(2):123-5 - PubMed
- Am J Sports Med. 1991 Jul-Aug;19(4):421 - PubMed
- Surgery. 2011 Jul;150(1):99-107 - PubMed
- Knee Surg Sports Traumatol Arthrosc. 2007 Aug;15(8):1041-7 - PubMed
- J Laparoendosc Adv Surg Tech A. 2008 Oct;18(5):669-72 - PubMed
- Hernia. 2010 Feb;14(1):27-33 - PubMed
- Clin Orthop Relat Res. 2007 Feb;455:78-87 - PubMed
- Br J Surg. 1997 Feb;84(2):213-5 - PubMed
- Lancet. 1999 Feb 6;353(9151):439-43 - PubMed
- Br J Sports Med. 1998 Jun;32(2):134-9 - PubMed
- Int Orthop. 2012 May;36(5):903-14 - PubMed
- Arthroscopy. 2010 Feb;26(2):161-72 - PubMed
- Surg Laparosc Endosc Percutan Tech. 2004 Aug;14(4):215-8 - PubMed
- Am J Sports Med. 2008 Nov;36(11):2187-95 - PubMed
- Am J Sports Med. 2000 Jan-Feb;28(1):2-8 - PubMed
- Scand J Med Sci Sports. 1999 Apr;9(2):98-103 - PubMed
- Hernia. 2010 Feb;14(1):5-15 - PubMed
- Arthroscopy. 2011 Jun;27(6):768-75 - PubMed
- Br J Sports Med. 2008 Dec;42(12):954-64 - PubMed
- Br J Sports Med. 1993 Mar;27(1):58-62 - PubMed
- Med Sci Monit. 2004 Feb;10(2):CR52-4 - PubMed
- Clin J Sport Med. 2008 May;18(3):221-6 - PubMed
- Br J Sports Med. 2011 Jan;45(1):6-9 - PubMed
- J Sci Med Sport. 2004 Dec;7(4):415-21; discussion 422-3 - PubMed
- Am J Sports Med. 2004 Jun;32(4):944-9 - PubMed
- Arthroscopy. 2013 Mar;29(3):405-10 - PubMed
- Hernia. 2010 Feb;14(1):17-25 - PubMed
- Int Orthop. 2012 Nov;36(11):2361-5 - PubMed
- Acta Radiol. 2002 Nov;43(6):603-8 - PubMed
- J Pediatr Orthop. 2008 Oct-Nov;28(7):705-10 - PubMed
- Arthroscopy. 2012 Oct;28(10 ):1396-403 - PubMed
- Surg Endosc. 2007 Feb;21(2):189-93 - PubMed
- Br J Sports Med. 1978 Sep;12 (3):129-33 - PubMed
- Curr Sports Med Rep. 2002 Apr;1(2):121-4 - PubMed
- Aust J Sci Med Sport. 1995 Sep;27(3):76-9 - PubMed
- J Orthop Surg (Hong Kong). 2007 Apr;15(1):46-9 - PubMed
- PM R. 2013 May;5(5):418-26 - PubMed
- Hernia. 2014;18(6):815-23 - PubMed
- J Bone Joint Surg Am. 2011 Oct 5;93(19):e111(1-10) - PubMed
- J Pediatr Orthop. 2008 Dec;28(8):806-11 - PubMed
- J Am Coll Surg. 2008 Jan;206(1):154-64 - PubMed
- Clin Orthop Relat Res. 2008 Feb;466(2):264-72 - PubMed
- Med Sci Sports Exerc. 2004 Dec;36(12):2040-5 - PubMed
- Sports Health. 2010 May;2(3):216-21 - PubMed
- J Laparoendosc Adv Surg Tech A. 2002 Apr;12(2):101-6 - PubMed
- J Orthop Sports Phys Ther. 2000 Jun;30(6):329-32 - PubMed
- Scand J Med Sci Sports. 2005 Feb;15(1):36-42 - PubMed
- Hernia. 2012 Jun;16(3):307-14 - PubMed
- Am J Sports Med. 2011 Jul;39 Suppl:14S-9S - PubMed
- Surgery. 2001 Oct;130(4):759-64; discussion 764-6 - PubMed
- Proc (Bayl Univ Med Cent). 2011 Apr;24(2):89-91 - PubMed
- Clin Orthop Relat Res. 2003 Dec;(417):112-20 - PubMed
- Am J Sports Med. 2004 Jul-Aug;32(5):1238-42 - PubMed
- Med J Aust. 1991 Nov 18;155(10):674-7 - PubMed
- Sports Health. 2014 Mar;6(2):171-7 - PubMed
- Br J Sports Med. 2014 Aug;48(16):1240-4 - PubMed
- Prim Care. 2005 Mar;32(1):163-83 - PubMed
- Am J Sports Med. 2001 Mar-Apr;29(2):124-8 - PubMed
- Am J Sports Med. 2013 Mar;41(3):603-7 - PubMed
- J Sci Med Sport. 2007 Dec;10(6):463-6 - PubMed
- Acta Radiol Diagn (Stockh). 1984;25(3):225-9 - PubMed
- Sports Med. 1988 Jul;6(1):56-61 - PubMed
- Clin Sports Med. 1998 Oct;17(4):787-93, vii - PubMed
- Am J Sports Med. 2001 Jul-Aug;29(4):521-33 - PubMed
Publication Types