TY - JOUR
T1 - Athletic groin pain: a systematic review of surgical diagnoses, investigations and treatment.
AU - de Sa, Darren
AU - Holmich, Per
AU - Phillips, Mark
AU - Heaven, Sebastian
AU - Simunovic, Nicole
AU - Philippon, Marc J.
AU - Ayeni, Olufemi R.
PY - 2016
Y1 - 2016
N2 - INTRODUCTION: Athletic groin pain requiring surgery remains a diagnostic and therapeutic challenge. This systematic review aims to identify the most common causes of groin pain in athletes requiring surgery. Additionally, it aims to further characterise their susceptible athlete profiles, common physical examination and imaging techniques, and surgical procedures performed. This will enable the orthopaedic sports medicine clinician/surgeon to best treat these patients. MATERIALS AND METHODS: The electronic databases MEDLINE, PubMed and EMBASE were searched from database inception to 13 August 2014 for studies in the English language that addressed athletic groin pain necessitating surgery. The search was updated on 4 August 2015 to find any articles published after the original search. The studies were systematically screened and data were abstracted in duplicate, with descriptive data presented. RESULTS: A total of 73 articles were included within our study, with data from 4655 patients abstracted. Overall, intra-articular and extra-articular causes of groin pain in athletes requiring surgery were equal. The top five causes for pain were: femoroacetabular impingement (FAI) (32%), athletic pubalgia (24%), adductor-related pathology (12%), inguinal pathology (10%) and labral pathology (5%), with 35% of this labral pathology specifically attributed to FAI. CONCLUSIONS: Given the complex anatomy, equal intra-articular and extra-articular contribution, and potential for overlap of clinical entities causing groin pain leading to surgery in athletes, further studies are required to ascertain the finer details regarding specific exam manoeuvres, imaging views and surgical outcomes to best treat this patient population.
AB - INTRODUCTION: Athletic groin pain requiring surgery remains a diagnostic and therapeutic challenge. This systematic review aims to identify the most common causes of groin pain in athletes requiring surgery. Additionally, it aims to further characterise their susceptible athlete profiles, common physical examination and imaging techniques, and surgical procedures performed. This will enable the orthopaedic sports medicine clinician/surgeon to best treat these patients. MATERIALS AND METHODS: The electronic databases MEDLINE, PubMed and EMBASE were searched from database inception to 13 August 2014 for studies in the English language that addressed athletic groin pain necessitating surgery. The search was updated on 4 August 2015 to find any articles published after the original search. The studies were systematically screened and data were abstracted in duplicate, with descriptive data presented. RESULTS: A total of 73 articles were included within our study, with data from 4655 patients abstracted. Overall, intra-articular and extra-articular causes of groin pain in athletes requiring surgery were equal. The top five causes for pain were: femoroacetabular impingement (FAI) (32%), athletic pubalgia (24%), adductor-related pathology (12%), inguinal pathology (10%) and labral pathology (5%), with 35% of this labral pathology specifically attributed to FAI. CONCLUSIONS: Given the complex anatomy, equal intra-articular and extra-articular contribution, and potential for overlap of clinical entities causing groin pain leading to surgery in athletes, further studies are required to ascertain the finer details regarding specific exam manoeuvres, imaging views and surgical outcomes to best treat this patient population.
KW - Athletes
KW - Groin
KW - Physical Examination
KW - Hip
KW - Humans
KW - Review
KW - Athletic Injuries/diagnosis/surgery
KW - Groin/injuries/pathology
KW - Musculoskeletal Pain/diagnosis
KW - Pelvic Pain/diagnosis/surgery
KW - Surgery
U2 - 10.1136/bjsports-2015-095137
DO - 10.1136/bjsports-2015-095137
M3 - Journal article
SN - 1473-0480
VL - 50
SP - 1181
EP - 1186
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 19
ER -