Boettcher Brennan J, Hollman John H, Stuart Michael J, Finnoff Jonathan T
Summit Orthopedics, Sports Medicine, Eagan, Minnesota, USA.
Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
Orthop J Sports Med. 2019 Aug 26;7(8):2325967119866010. doi: 10.1177/2325967119866010. eCollection 2019 Aug.
Adductor longus tendinopathy is a well-known etiology of chronic groin pain in elite athletes. Surgery is indicated for those who fail conservative treatment. No studies to date have evaluated the feasibility of an ultrasound-guided release of the proximal adductor longus tendon.
PURPOSE/HYPOTHESIS: The primary aim of this study was to determine the feasibility of an ultrasound-guided selective adductor longus release with a cutting wire. A secondary aim was to determine safety by avoiding injury to adjacent structures. We hypothesized that the proximal adductor longus tendon can be released under ultrasound guidance with a cutting wire without injury to adjacent neurovascular or genitourinary structures.
Descriptive laboratory study.
Ten adductor longus tendons (5 cadaveric specimens) from 4 males and 1 female between 76 and 89 years of age with a mean body mass index of 21.9 kg/m (range, 16.8-29.6 kg/m) were used during this study. A single experienced physician sonographer performed ultrasound-guided proximal adductor longus tendon releases on all cadaveric specimens using a cutting wire. Dissection was performed by a second physician to determine the completeness of the tendon transections and to detect injury to adjacent neurovascular or genitourinary structures.
All 10 adductor longus tendons were transected. Eight of 10 transections were complete, whereas in 2 transections, >99% of the tendon was transected. There were no injuries to adjacent genitourinary or neurovascular structures.
Ultrasound-guided adductor tendon release is feasible and safe in a cadaveric model. Further translational research should be performed to determine whether these results can be replicated in the clinical setting.
Adductor longus tendinopathy frequently requires surgical intervention and prolonged time away from sport. The present study suggests that a selective adductor longus tendon release can be performed with ultrasound guidance. This procedure warrants further translational research to explore its use in clinical practice.
内收长肌腱病是精英运动员慢性腹股沟疼痛的一个常见病因。对于保守治疗无效的患者，可考虑手术治疗。迄今为止，尚无研究评估超声引导下近端内收长肌腱松解术的可行性。
目的/假设：本研究的主要目的是确定使用切割线进行超声引导下选择性内收长肌松解术的可行性。次要目的是通过避免损伤相邻结构来确定安全性。我们假设在超声引导下使用切割线可以切断近端内收长肌腱，而不会损伤相邻的神经血管或泌尿生殖结构。
描述性实验室研究。
本研究使用了10条内收长肌腱（5个尸体标本），来自4名男性和1名女性，年龄在76至89岁之间，平均体重指数为21.9 kg/m²（范围为16.8 - 29.6 kg/m²）。由一名经验丰富的超声科医生使用切割线对所有尸体标本进行超声引导下近端内收长肌腱松解术。由另一名医生进行解剖，以确定肌腱切断的完整性，并检测相邻神经血管或泌尿生殖结构是否受损。
10条内收长肌腱均被切断。10次切断中有8次完全切断，另外2次切断中，超过99%的肌腱被切断。相邻的泌尿生殖或神经血管结构未受损伤。
在尸体模型中，超声引导下内收肌腱松解术是可行且安全的。应进行进一步的转化研究，以确定这些结果是否能在临床环境中得到复制。
内收长肌腱病常常需要手术干预，且运动员会因此长时间远离运动。本研究表明，在超声引导下可以进行选择性内收长肌腱松解术。该手术值得进一步的转化研究，以探索其在临床实践中的应用。
