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Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 11, pp 1595–1599 | Cite as

Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration

  • Sascha HoppEmail author
  • Masjudin Tumin
  • Peter Wilhelm
  • Tim Pohlemann
  • Jens Kelm
Arthroscopy and Sports Medicine

Abstract

We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting.

Keywords

Arthroscopy Pubic symphysis Osteitis pubis Debridement Adductor enthesopathy Athletes 

Notes

Conflict of interest

No conflicts of interest at all.

Supplementary material

Video 1 The video demonstrates the complete surgical procedure from cut to stitch. It is illustrated on the basis of a case of a young 24 year old competitive football player diagnosed with a degenerative osteitis pubis and a chronic proximal adductor longus enthesopathy on the right side. Soft tissue preparation in the groin as a precondition for the installation of the portals was emphasized in the video (WMV 256650 kb)

References

  1. 1.
    Batt ME, McShane JM, Dillingham MF (1995) Osteitis pubis in collegiate football players. Med Sci Sports Exerc 27:629–633PubMedCrossRefGoogle Scholar
  2. 2.
    Hiti CJ, Stevens KJ, Jamati MK, Garza D, Matheson GO (2011) Athletic Osteitis Pubis. Sports Med 41(5):361–376PubMedCrossRefGoogle Scholar
  3. 3.
    Radic R, Annear P (2008) Use of pubic symphysis curettage for treatment-resistant osteitis pubis in athletes. Am J Sports Med 36:122–128PubMedCrossRefGoogle Scholar
  4. 4.
    Brennan D, O´Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C, O´Neill P, Eustace S (2005) Secondary cleft sign as a marker on injury in athletes with groin pain: MR image appearance and interpretation. Radiology 235:162–167PubMedCrossRefGoogle Scholar
  5. 5.
    Cunningham PM, Brennan D, O´Connell M, MacMahon P, O´Neill P, Eustace S (2007) Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI. AJR 188:291–296CrossRefGoogle Scholar
  6. 6.
    Grace JN, Sim FH, Shives TC, Coventry MB (1989) Wedge resection of the symphysis pubis for the treatment of osteitis pubis. J Bone Jt Surg Am 71:358–364Google Scholar
  7. 7.
    Moore RS Jr, Stover MD, Matta JM (1998) Late posterior instability of the pelvis after resection of the symphysis pubis for the treatment of osteitis pubis. A report of two cases. J Bone Jt Surg Am 80:1043–1048CrossRefGoogle Scholar
  8. 8.
    Williams PR, Thomas DP, Downes EM (2000) Osteitis pubis and instability of the pubic symphysis. When nonoperative measures fail. Am J Sports Med 28:350–355PubMedGoogle Scholar
  9. 9.
    Hechtman KS, Zvijac JE, Popkin CA, Zych GA, Botto-van Bemden A (2010) A minimally disruptive surgical technique for the treatment of osteitis pubis in athletes. Orthopedics 2:210–215Google Scholar
  10. 10.
    Mehin R, Meek R, O´Brien P, Blachut P (2006) 17. Can J Surg 49(3):170PubMedPubMedCentralGoogle Scholar
  11. 11.
    Robinson P, Salehi F, Grainger A, Clemence M, Schilders E, O´Connor P, Agut A (2007) Cadaveric and MRI Study of the musculotendinous contributions to the capsule of the symphysis pubis. Am J Rad 188:440–445Google Scholar
  12. 12.
    Becker I, Woodley SJ, Stringer MD (2010) The adult human pubic symphysis: a systematic review. J Anat 217:475–487PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Hopp S, Culemann U, Kelm J, Pohlemann T, Pizanis A (2013) Osteitis pubis and adductor tendinopathy in athletes—a novel arthroscopic pubic symphysis curettage and adductor reattachment. Arch Orthop Trauma Surg 133(7):1003–1009PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Sascha Hopp
    • 1
    Email author
  • Masjudin Tumin
    • 2
  • Peter Wilhelm
    • 1
  • Tim Pohlemann
    • 1
  • Jens Kelm
    • 3
  1. 1.Department of Trauma, Hand and Reconstructive SurgeryUniversity of SaarlandHomburg/SaarGermany
  2. 2.Department of Orthopaedic and Trauma SurgerySultanah Aminah HospitalJohor BahruMalaysia
  3. 3.Center of general and Orthopedic SurgeryIllingenGermany

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