The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

Strosberg, David S.; Ellis, Thomas J.; Renton, David

doi:10.3389/fsurg.2016.00006

Cited by 26 publications

(18 citation statements)

References 18 publications

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“…Recently, some authors demonstrated the association between osteitis pubis/athletic pubalgia and femoroacetabular impingement (FAI) 44,45. In these patients, better results have been reported after treatment of both intra and extra-articular pathologies, with a high rate of return to previous level of activity/sport 46,47…”

Section: Treatment and Return To Sportmentioning

confidence: 99%

Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

VIa¹,

Frizziero²,

Finotti³

et al. 2018

OAJSM

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Osteitis pubis is a common cause of chronic groin pain, especially in athletes. Although a precise etiology is not defined, it seems to be related to muscular imbalance and pelvic instability. Diagnosis is based on detailed history, clinical evaluation, and imaging, which are crucial for a correct diagnosis and proper management. Many different therapeutic approaches have been proposed for osteitis pubis; conservative treatment represents the first-line approach and provides good results in most patients, especially if based on an individualized multimodal rehabilitative management. Different surgical options have been also described, but they should be reserved to recalcitrant cases. In this review, a critical analysis of the literature about athletic osteitis pubis is performed, especially focusing on its diagnostic and therapeutic management.

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Section: Treatment and Return To Sportmentioning

confidence: 99%

Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

VIa¹,

Frizziero²,

Finotti³

et al. 2018

OAJSM

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show abstract

“…Combined surgical treatment of concomitant hip and CMIs has been described 15,16 and is a safe and effective treatment in our experience (unpublished). Should these procedures be staged, there is no evidence that one should be performed before the other, and, in our experience, more than 2 weeks is not necessary between procedures.…”

Section: Operative Considerationsmentioning

confidence: 85%

Hip Pain in Athletes: Part 1—How to Work Up, Diagnose, and Manage Core Muscle Injuries (Athletic Pubalgia)

Poor¹,

Roedl

Zoga

et al. 2018

J Hip Surg

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Lower abdominal and groin injuries are among the most common causes of pain in athletes. Those that involve the skeletal muscles of the core, defined as the entire body from the chest to the midthigh, are called core muscle injuries. In this review, the authors will describe the anatomy and pathophysiology of core muscle injuries in detail, as well as the appropriate work-up and management. Special consideration is given to the important interrelationship between core muscle injuries and intrinsic hip pathology, such as femoroacetabular impingement, and to the drawbacks of treating these injuries with platelet-rich plasma.

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“…These include the nonspecific symptoms and clinical findings during examination as well as the other potential causes of groin pain (such as FAI and associated acetabular labral tears) in athletes. 2 , 22 , 23 In many athletes, groin pain may be the result of a combination of findings, and the clinician must decipher the symptomatic pathology that requires surgical treatment. As a result, there is a lack of standardized diagnostic workup for a CMI.…”

Section: Discussionmentioning

confidence: 99%

Use of Preoperative Magnetic Resonance Imaging to Predict Clinical Outcomes After Core Muscle Injury Repair

Kraeutler

Kurowicki

Castrodad

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Core muscle injury (CMI), often referred to as a sports hernia or athletic pubalgia, is a common cause of groin pain in athletes. Imaging modalities used to assist in the diagnosis of CMI include ultrasound (US) and magnetic resonance imaging (MRI). Purpose: To determine if preoperative MRI findings predict clinical outcomes after surgery for CMI. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study was performed on a consecutive series of patients who were operatively treated for CMI by a single surgeon. CMI was diagnosed based on history, physical examination, and a positive US. In addition, all patients underwent a preoperative MRI. Patients were divided into 2 groups based on whether the MRI was interpreted as positive or negative for CMI. All patients underwent mini-open CMI repair. Patient-reported outcomes (PROs) were collected both pre- and postoperatively and included a visual analog scale (VAS) for pain, the University of California, Los Angeles (UCLA) activity score, and the modified Harris Hip Score. Results: A total of 39 hips were included in this study, of which 17 had a positive MRI interpretation for CMI (44%) and 22 had a negative MRI interpretation (56%). Mean age at the time of surgery was 35 years (range, 17-56 years), and mean follow-up was 21 months (range, 12-35 months). No significant difference was found between groups in mean age or time to follow-up. Patients in both groups demonstrated significant improvement from preoperative to most recent follow-up in terms of the UCLA activity score ( P < .05). VAS scores significantly improved for patients with a positive MRI interpretation ( P = .001) but not for those with a negative MRI interpretation ( P = .094). No significant difference on any PROs was found between groups at the most recent follow-up. Conclusion: Successful clinical outcomes can be expected in patients undergoing surgery for CMI diagnosed based on history, physical examination, and US. Patients with a preoperative MRI consistent with CMI may experience greater improvement in pain postoperatively, although MRI does not predict postoperative activity level in these patients.

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The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

Cited by 26 publications

References 18 publications

Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

Hip Pain in Athletes: Part 1—How to Work Up, Diagnose, and Manage Core Muscle Injuries (Athletic Pubalgia)

Use of Preoperative Magnetic Resonance Imaging to Predict Clinical Outcomes After Core Muscle Injury Repair

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The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

Cited by 26 publications

References 18 publications

Management of osteitis pubis in athletes: rehabilitation and return to training &ndash; a review of the most recent literature

Management of osteitis pubis in athletes: rehabilitation and return to training &ndash; a review of the most recent literature

Hip Pain in Athletes: Part 1—How to Work Up, Diagnose, and Manage Core Muscle Injuries (Athletic Pubalgia)

Use of Preoperative Magnetic Resonance Imaging to Predict Clinical Outcomes After Core Muscle Injury Repair

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Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature