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. 2018 Jul 17;6(7):2325967118784898.
doi: 10.1177/2325967118784898. eCollection 2018 Jul.

Proximal Adductor Avulsion Injuries: Outcomes of Surgical Reattachment in Athletes

Srino Bharam  1 , Daniel P Feghhi  1 , David A Porter  1 , Priyal V Bhagat  1
Affiliations

Proximal Adductor Avulsion Injuries: Outcomes of Surgical Reattachment in Athletes

Srino Bharam et al. Orthop J Sports Med. .

Abstract

Background: Sports-related groin injuries are common among athletes. However, traumatic proximal adductor avulsion injuries are relatively rare groin injuries in the athletic population, with limited case reports describing suture anchor repair.

Purpose: To report on the outcomes of surgical reattachment of proximal adductor avulsion injuries in athletes utilizing a suture anchor repair technique.

Study design: Case series; Level of evidence, 4.

Methods: Prospective data were collected on patients undergoing surgical reattachment of proximal adductor avulsion injuries from December 2012 to May 2015 by a single surgeon. Six athletes presented after a traumatic sports-related injury with disabling groin pain, adductor weakness, and magnetic resonance imaging confirmation of fibrocartilage avulsion of the proximal adductor with retraction. Patient-reported outcomes (Hip Outcome Score-Activities of Daily Living [HOS-ADL] and Hip Outcome Score-Sport Specific [SS] subscales, modified Harris Hip Score [mHHS], and visual analog scale [VAS] for pain) were collected preoperatively and at a minimum 2-year follow-up.

Results: The latest follow-up of each patient averaged 33.4 months postoperatively (range, 25-42.5 months). All patients returned to sporting activities, with 1 minor wound complication that resolved. Paired-samples t tests indicated that the mean latest postoperative scores for all patients were significantly better than their mean preoperative scores (HOS-ADL: 99.0 vs 43.2, HOS-SS: 98.9 vs 8.3, and mHHS: 97.1 vs 44.6, respectively; P < .001 for all). Similarly, there was a significant improvement in mean postoperative VAS scores for all patients (from 89.2 to 2.2; P < .001).

Conclusion: Patient-reported outcomes offer an objective measure of hip function and pain control. Surgical reattachment utilizing a multiple suture anchor technique is a successful procedure that allows for a safe return to athletic performance and a predictable return to sport.

Keywords: groin pain; hip; repair; tendon rupture.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: S.B. has received hospitality payments from Smith & Nephew and Pivot Medical, has received educational payments from Arthrex, is a paid speaker/presenter for Smith & Nephew, and is a consultant for Smith & Nephew.

Figures

Figure 1.
Figure 1.
(A) Oblique fat-saturated T2-weighted and (B) proton density–weighted (PD) magnetic resonance imaging (MRI) scans demonstrating a right-sided adductor avulsion injury with 1.7 cm of retraction and fluid signal between the tendon complex and superior ramus (blue arrows). (C) Sagittal PD MRI scan demonstrating an adductor avulsion injury and tendon retraction (blue arrow).
Figure 2.
Figure 2.
(A) Coronal T1-weighted and (B) axial proton density–weighted magnetic resonance imaging scan demonstrating a healed left-sided adductor avulsion repair site (blue arrow).
See this image and copyright information in PMC

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