Early recovery after endoscopic totally extraperitoneal (TEP) hernia repair in athletes with inguinal disruption: A prospective cohort study
Autoři:
Erwin Brans aff001; Inge H. F. Reininga aff003; Hans Balink aff004; Arvid V. E. Munzebrock aff001; Bram Bessem aff002; Joost S. de Graaf aff001
Působiště autorů:
Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands
aff001; University of Groningen, University Medical Center Groningen, Center for Sports Medicine, Groningen, The Netherlands
aff002; University of Groningen, University Medical Center Groningen, Department of Trauma Surgery, Groningen, The Netherlands
aff003; Department of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
aff004
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0226011
Souhrn
Background
Groin pain is a common problem in athletes which results in loss of playing time. Moreover, it can be for the cause of athletic career termination. A common cause of groin pain in athletes is inguinal disruption; pain in the groin area near the pubic tubercle were no obvious other pathology exists to explain the symptoms. Aim of this study was to evaluate the effect of endoscopic totally extraperitoneal (TEP) hernia repair in athletes with inguinal disruption.
Methods
Thirty-one athletes with chronic groin pain due to inguinal disruption, who had undergone conservative therapy without any effect, were included in this prospective cohort study. Prior to surgery patients were assessed by clinical examination, ultrasound of the inguinal region, x-ray and a radionuclide bone scan with single photon-emission computed tomography and CT (SPECT-CT). TEP hernia repair was performed and a lightweight polypropylene mesh was placed pre-peritoneally. Additionally the athletes’ perception about their groin disability was assessed preoperatively and 6 weeks postoperatively by means of the Hip and Groin Outcome Score (HAGOS). The HAGOS consists of six subscales: Pain, Symptoms, Physical function in daily living, Physical function in Sport and Recreation, Participation in Physical Activities, and hip and/or groin-related Quality of Life.
Results
No complications occurred during and after surgery. After six weeks patients improved in all the separate subscales of the Hip and Groin Outcome Score (HAGOS). Within 6 weeks of surgery, 26 patients (84%) returned to sports activities with no or less groin pain.
Conclusions
This study showed that endoscopic totally extraperitoneal (TEP) hernia repair is an effective surgical treatment of inguinal disruption in athletes with chronic groin pain.
Klíčová slova:
Endoscopy – Hernia – Magnetic resonance imaging – Quality of life – Sports – Surgical and invasive medical procedures – Surgical repair – Ultrasound imaging
Zdroje
1. Holmich P Bradshaw CIn: Brukner, Bahr P, Blair R, S et al. In: Anonymous Brukner and Khan's Clinical Sports Medicine.: Sydney:McGraw-Hill; 2012. pp. 545–78.
2. Paajanen H, Ristolainen L, Turunen H, Kujala UM. Prevalence and etiological factors of sport-related groin injuries in top-level soccer compared to non-contact sports. Arch Orthop Trauma Surg. 2011;131: 261–266. doi: 10.1007/s00402-010-1169-1 20714902
3. Sheen AJ, Stephenson BM, Lloyd DM, Robinson P, Fevre D, Paajanen H, et al. 'Treatment of the sportsman's groin': British Hernia Society's 2014 position statement based on the Manchester Consensus Conference. Br J Sports Med. 2014;48: 1079–1087. doi: 10.1136/bjsports-2013-092872 24149096
4. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan KM, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015;49: 768–774. doi: 10.1136/bjsports-2015-094869 26031643
5. Susmallian S, Ezri T, Elis M, Warters R, Charuzi I, Muggia-Sullam M. Laparoscopic repair of "sportsman's hernia" in soccer players as treatment of chronic inguinal pain. Med Sci Monit. 2004;10: CR52–4. 14737043
6. Paajanen H, Brinck T, Hermunen H, Airo I. Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: a randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman's hernia (athletic pubalgia). Surgery. 2011;150: 99–107. doi: 10.1016/j.surg.2011.02.016 21549403
7. Genitsaris M, Goulimaris I, Sikas N. Laparoscopic repair of groin pain in athletes. Am J Sports Med. 2004;32: 1238–1242. doi: 10.1177/0363546503262203 15262648
8. Macintyre J, Johson C, Schroeder EL. Groin pain in athletes. Curr Sports Med Rep. 2006;5: 293–299. doi: 10.1097/01.csmr.0000306433.28983.c7 17067496
9. Verrall GM, Slavotinek JP, Fon GT, Barnes PG. Outcome of conservative management of athletic chronic groin injury diagnosed as pubic bone stress injury. Am J Sports Med. 2007;35: 467–474. doi: 10.1177/0363546506295180 17267768
10. Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet. 1999;353: 439–443. doi: 10.1016/S0140-6736(98)03340-6 9989713
11. Caudill P, Nyland J, Smith C, Yerasimides J, Lach J. Sports hernias: a systematic literature review. Br J Sports Med. 2008;42: 954–964. doi: 10.1136/bjsm.2008.047373 18603584
12. Ekberg O, Persson NH, Abrahamsson PA, Westlin NE, Lilja B. Longstanding groin pain in athletes. A multidisciplinary approach. Sports Med. 1988;6: 56–61. doi: 10.2165/00007256-198806010-00006 3175403
13. Polglase AL, Frydman GM, Farmer KC. Inguinal surgery for debilitating chronic groin pain in athletes. Med J Aust. 1991;155: 674–677. 1943896
14. van Veen RN, de Baat P, Heijboer MP, Kazemier G, Punt BJ, Dwarkasing RS, et al. Successful endoscopic treatment of chronic groin pain in athletes. Surg Endosc. 2007;21: 189–193. doi: 10.1007/s00464-005-0781-6 17122983
15. Sheen AJ, Montgomery A, Simon T, Ilves I, Paajanen H. Randomized clinical trial of open suture repair versus totally extraperitoneal repair for treatment of sportsman's hernia. Br J Surg. 2019;106: 837–844. doi: 10.1002/bjs.11226 31162653
16. Harmon KG. Evaluation of groin pain in athletes. Curr Sports Med Rep. 2007;6: 354–361. 18001606
17. Swan KG Jr, Wolcott M. The athletic hernia: a systematic review. Clin Orthop Relat Res. 2007;455: 78–87. doi: 10.1097/BLO.0b013e31802eb3ea 17146362
18. Liem MS, van der Graaf Y, van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS, et al. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med. 1997;336: 1541–1547. doi: 10.1056/NEJM199705293362201 9164809
19. Srinivasan A, Schuricht A. Long-term follow-up of laparoscopic preperitoneal hernia repair in professional athletes. J Laparoendosc Adv Surg Tech A. 2002;12: 101–106. doi: 10.1089/10926420252939600 12019567
20. Roos MM, Bakker WJ, Goedhart EA, Verleisdonk EJMM, Clevers GJ, Voorbrood CEH, et al. Athletes with inguinal disruption benefit from endoscopic totally extraperitoneal (TEP) repair. Hernia. 2018;22: 517–524. doi: 10.1007/s10029-018-1741-0 29383598
21. Thorborg K, Holmich P, Christensen R, Petersen J, Roos EM. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med. 2011;45: 478–491. doi: 10.1136/bjsm.2010.080937 21478502
22. Holmich P, Holmich LR, Bjerg AM. Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study. Br J Sports Med. 2004;38: 446–451. doi: 10.1136/bjsm.2003.004754 15273182
23. Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg. 1991;28: 401–450. doi: 10.1016/0011-3840(91)90028-n 2032462
24. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 2010;10: 22-2288–10-22.
25. Brans E, de Graaf JS, Munzebrock AV, Bessem B, Reininga IH. Cross-Cultural Adaptation and Validation of the Dutch Version of the Hip and Groin Outcome Score (HAGOS-NL). PLoS One. 2016;11: e0148119. doi: 10.1371/journal.pone.0148119 26821266
26. Efron B TR. Bootstrap measures for standart errors, confidence intervals, and other measures of statistical accuracy. Statistical Science (1). 1986: 54–77.
27. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995;27: 76–79. 8599748
28. Miller J, Cho J, Michael MJ, Saouaf R, Towfigh S. Role of imaging in the diagnosis of occult hernias. JAMA Surg. 2014;149: 1077–1080. doi: 10.1001/jamasurg.2014.484 25141884
29. Lovell G, Galloway H, Hopkins W, Harvey A. Osteitis pubis and assessment of bone marrow edema at the pubic symphysis with MRI in an elite junior male soccer squad. Clin J Sport Med. 2006;16: 117–122. doi: 10.1097/00042752-200603000-00006 16603880
30. Kopelman D, Kaplan U, Hatoum OA, Abaya N, Karni D, Berber A, et al. The management of sportsman's groin hernia in professional and amateur soccer players: a revised concept. Hernia. 2016;20: 69–75. doi: 10.1007/s10029-014-1322-9 25380561
31. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 2010;10: 22-2288–10-22.
32. Kemp JL, Collins NJ, Roos EM, Crossley KM. Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery. Am J Sports Med. 2013;41: 2065–2073. doi: 10.1177/0363546513494173 23835268
33. Branco RC, da Costa Fontenelle CR, Miranda LM, Junior YA, Vianna EM. Comparative Study between the Pubis of Asymptomatic Athletes and Non-Athletes with Mri. Rev Bras Ortop. 2015;45: 596–600. doi: 10.1016/S2255-4971(15)30309-8 27026970
34. Huellner MW, Burkert A, Schleich FS, Schurch M, Hug U, von Wartburg U, et al. SPECT/CT versus MRI in patients with nonspecific pain of the hand and wrist—a pilot study. Eur J Nucl Med Mol Imaging. 2012;39: 750–759. doi: 10.1007/s00259-011-2034-3 22237845
35. Ha S, Hong SH, Paeng JC, Lee DY, Cheon GJ, Arya A, et al. Comparison of SPECT/CT and MRI in diagnosing symptomatic lesions in ankle and foot pain patients: diagnostic performance and relation to lesion type. PLoS One. 2015;10: e0117583. doi: 10.1371/journal.pone.0117583 25668182
36. Tenery R, Rakatansky H, Riddick FA Jr, Goldrich MS, Morse LJ, O'Bannon JM,3rd, et al. Surgical "placebo" controls. Ann Surg. 2002;235: 303–307. doi: 10.1097/00000658-200202000-00021 11807373
37. Farber AJ, Wilckens JH. Sports hernia: diagnosis and therapeutic approach. J Am Acad Orthop Surg. 2007;15: 507–514. doi: 10.5435/00124635-200708000-00007 17664370
Článek vyšel v časopise
PLOS One
2019 Číslo 12
- S diagnostikou Parkinsonovy nemoci může nově pomoci AI nástroj pro hodnocení mrkacího reflexu
- Je libo čepici místo mozkového implantátu?
- Pomůže v budoucnu s triáží na pohotovostech umělá inteligence?
- AI může chirurgům poskytnout cenná data i zpětnou vazbu v reálném čase
- Nová metoda odlišení nádorové tkáně může zpřesnit resekci glioblastomů
Nejčtenější v tomto čísle
- Methylsulfonylmethane increases osteogenesis and regulates the mineralization of the matrix by transglutaminase 2 in SHED cells
- Oregano powder reduces Streptococcus and increases SCFA concentration in a mixed bacterial culture assay
- The characteristic of patulous eustachian tube patients diagnosed by the JOS diagnostic criteria
- Parametric CAD modeling for open source scientific hardware: Comparing OpenSCAD and FreeCAD Python scripts
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy