Sports Division, Institute of Orthopedics and Traumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (IOT HC FMUSP), São Paulo, 05403902, Brazil.
Sports Division, Institute of Orthopedics and Traumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (IOT HC FMUSP), São Paulo, 05403902, Brazil.
J ISAKOS. 2024 Feb;9(1):16-24. doi: 10.1016/j.jisako.2023.10.013. Epub 2023 Nov 4.
Core muscle injury is a debilitating condition that causes chronic groin pain in athletes, particularly common in soccer players. The condition is characterised by pain in the inguinal region and can lead to a significant number of absences from high-intensity physical activity. It is caused by repetitive overload without proper counterbalance from the abdominal muscles, hip flexors, and adductors in susceptible athletes. Surgical indications for core muscle injury consider cases where non-surgical treatments have not provided sufficient relief. The aim of this study was to assess the results of surgical intervention for core muscle injury using the technique employed by the Sports Medicine Group of (Institute of Orthopedics and Traumatology of Hospital das Clínicas - Universidade de São Paulo). The procedure involves releasing the anterior portion of the tendon of the rectus abdominis muscle near the pubic symphysis, along with proximal tenotomy of the adductor longus muscle tendon.
This study utilised a consecutive historical cohort analysis of the medical records of 45 male athletes, of which, 75.6% were professional soccer players, who underwent surgical treatment between January 1, 2002, and December 31, 2021. The participants included active athletes aged between 18 and 40 years, with a mean age of 23.9 years, and were diagnosed with myotendinous core muscle injury. These athletes experienced pain in the pubic symphysis and adductor tendon region and had previously undergone medical treatment and physical therapy for a duration of three to six months without significant improvement.
The average time for athletes to return to sport after surgery was 135 days, with a majority of participants being soccer and futsal players. The surgical intervention yielded promising results, with a positive correlation between unilateral injuries and the time taken to return to sport. The complication rate was low, at 6.7%. Notably, the rate of symptom resolution was high, at 93.3%. Furthermore, the analysis indicated that the player's position on the field significantly influenced the discharge period, suggesting that the game position plays a role in the recovery process.
The combined surgical procedure involving the release of the rectus abdominis tendon and adductor longus muscle tenotomy demonstrates favourable outcomes for athletes with core muscle injury. This study provides strong support for the effectiveness of this surgical approach in managing the condition and offers a potential path to recovery and return to sports activities.
Cross-sectional study.
核心肌群损伤是一种使人衰弱的疾病，会导致运动员出现慢性腹股沟疼痛，在足球运动员中尤为常见。这种疾病的特征是腹股沟区域疼痛，会导致运动员大量缺席高强度体育活动。它是由于腹部肌肉、髋关节屈肌和内收肌的重复性超负荷而引起的，在易患运动员中尤为常见。核心肌群损伤的手术指征考虑到非手术治疗没有提供足够缓解的情况。本研究旨在评估 Sports Medicine Group（巴西圣保罗大学附属医院骨科和创伤学研究所）采用的手术干预核心肌群损伤的结果。该手术包括在耻骨联合附近释放腹直肌肌腱的前部分，以及长收肌肌腱的近端切断术。
本研究对 2002 年 1 月 1 日至 2021 年 12 月 31 日期间接受手术治疗的 45 名男性运动员的医疗记录进行了连续的历史队列分析，其中 75.6%为职业足球运动员。这些参与者是年龄在 18 至 40 岁之间的现役运动员，平均年龄为 23.9 岁，被诊断为肌腹核心肌群损伤。这些运动员在耻骨联合和内收肌腱区域感到疼痛，并且已经接受了 3 至 6 个月的药物治疗和物理治疗，但没有明显改善。
运动员手术后重返运动的平均时间为 135 天，大多数参与者是足球和五人制足球运动员。手术干预的结果令人满意，单侧损伤与重返运动所需时间之间存在正相关关系。并发症发生率低，为 6.7%。值得注意的是，症状缓解率很高，为 93.3%。此外，分析表明，球员在场上的位置对出院期有显著影响，表明比赛位置在恢复过程中发挥作用。
涉及腹直肌肌腱松解和长收肌肌腱切断术的联合手术程序为核心肌群损伤的运动员提供了良好的结果。本研究为这种手术方法治疗该疾病的有效性提供了强有力的支持，并为恢复和重返体育活动提供了潜在的途径。
横断面研究。
