Surgical or conservative treatment in ARGP syndrome? A systematic review
Keywords:
rectus-adductor syndrome, groin pain, athletes, return to playAbstract
Background and aim of the work: The rectus-adductor syndrome is a common cause of groin pain. In literature the adductor longus is reported as the most frequent site of injury so that the syndrome can be fitted into the adductor related groin pain (ARGP) group. The aim of this study was to define what is the best treatment between surgical and conservative in athletes affected by ARGP in terms of healing and return to play (RTP) time. Methods: A systematic review was performed searching for articles describing studies on RTP time for surgical or conservative interventions for ARGP. A qualitative synthesis was performed. Only 10 out 7607 articles were included in this systematic review. An exploratory meta-analysis was carried out. Due to high heterogeneity of the included studies, raw means of surgery and conservative treatment groups were pooled separately. A random effects model was used. Results: The results showed quicker RTP time for surgery when pooled raw means were compared to conservative treatments: 11,23 weeks (CI 95%, 8.18,14.28, p<0.0001, I^2=99%) vs 14,9 weeks (CI 95%, 13.05,16.76, p<0.0001, I^2 = 77%). The pooled results showed high statistical heterogeneity (I^2), especially in the surgical group. Conclusions: Surgical interventions are associated with quicker RTP time in athletes affected by ARGP, but due to the high heterogeneity of the available studies and the lack of dedicated RCTs this topic needs to be investigated with dedicated high quality RCT studies.
References
1. Šebečić B, Japjec M, Janković S, Čuljak V, Dojčinović B. Is chronic groin pain a Bermuda triangle of sports medicine?. Acta Clin Croat 2014; 53(4): 471-8.
2. Pogliacomi F, Costantino C, Pedrini MF, Pourjafar S, De Filippo M, Ceccarelli F. Anterior groin pain in athlete as consequence of bone diseases: aetiopathogenensis, diagnosis and principles of treatment. Medicina dello Sport 2014; 66(1): 1-27.
3. Pogliacomi F, Costantino C, Pedrini MF, Pourjafar S, De Filippo M, Ceccarelli F. Anterior groin pain in athletes as a consequence of intra-articular diseases: aetiopathogenensis, diagnosis and principles of treatment. Medicina dello Sport 2014; 66(3): 341-68.
4. Pogliacomi F, Pedrini MF, Pourjafar S, Pellegrini A, Paraskevopoulos A, Costantino C, Ceccarelli F. Pubalgia and soccer: real problem or overestimated? Medicina dello Sport 2015; 68(4): 641-62.
5. Di Benedetto P, Niccoli G, Beltrame A, Gisonni R, Cainero V, Causero A. Histopathological aspects and staging systems in non-traumatic femoral head osteonecrosis: an overview of the literature. Acta Biomed 2016 Apr 15; 87 Suppl 1: 15-24. Review.
6. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan K et al. “Doha agreement meeting on terminology and definitions in groin pain in athletes,” Br J Sports Med 2015; 49(12): 768-74.
7. Morelli V, Weaver V. Groin injuries and groin pain in athletes: Part 1 Prim. Care Clin. Off. Pract. 2005; 32(1): 137-83.
8. Bisciotti GN, Eirale C, Vuckovic Z, Le Picard P, D’Hooghe P, Chalabi H. La pubalgia dell’atleta: Una revisione della letteratura. Medicina dello Sport 2013; 65 (1): 119-33.
9. Brunt LM. Hernia Management in the Athlete. Adv Surg 2016; 50 (1): 187-202.
10. Trofa DP, Mayeux SE, Parisien RL, Ahmad CS, Lynch TS. Mastering the Physical Examination of the Athlete’s Hip. Am. J. Orthop. (Belle Mead. NJ) 2017; 46(1): 10-65.
11. de Sa D, Hölmich P, Phillips M, Heaven S1, Simunovic N, Philippon MJ. Athletic groin pain: a systematic review of surgical diagnoses, investigations and treatment. Br J Sports Med 2016 Oct; 50(19): 1181-6.
12. Anderson K, Strickland SM, Warren R. Hip and Groin Injuries in Athletes. Am. J Sports Med 2001; 29(4): 521-33.
13. Orso CA, Calabrese BF, D’Onofrio S, Passerini A. The rectus-adductor syndrome. The nosographic picture and treatment criteria. Ann. Ital. Chir 1990; 1(6): 647-9.
14. Estwanik JJ, Sloane B, Rosenberg MA. Groin Strain and Other Possible Causes of Groin Pain. Phys Sportsmed 1990 Feb;18(2):54-64.
15. Rennie W, Lloyd D. Sportsmans Groin: The Inguinal Ligament and the Lloyd Technique. J Belgian Soc Radiol 2018; 101(S2): 1-4.
16. Omar IM, Zoga AC, Kavanagh EC, Koulouris G, Bergin D, Gopez AG et al. Athletic Pubalgia and ‘Sports Hernia’:Optimal MR ImagingTechnique and Findings. RadioGraphics 2008; 28: 1415-38.
17. Riley G. The pathogenesis of tendinopathy. A molecular perspective. Rheumatology 2004; 43(2): 131-42.
18. Valent A, Frizziero A, Bressan S, Zanella E, Giannotti E, Masiero S. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review. Muscles Ligaments Tendons J 2012; 2(2): 142-8.
19. Santilli OL, Nardelli N, Santilli HA, Tripoloni DE. Sports hernias: experience in a sports medicine center. Hernia 2016; 20(1): 77-84.
20. Holmich P, Renstrom PA. Long-standing groin pain in sports people falls into three primary patterns, a ‘clinical entity’ approach: a prospective study of 207 patients * COMMENTARY. Br J Sports Med 2007; 41(4): 247-52.
21. Serner A, Tol JL, Jomaah N, Weir A, Whiteley R, Thorborg K ET AL. Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes. Am J Sports Med 2015 Aug; 43(8): 1857-63.
22. Järvinen TA, Järvinen TL, Kääriäinen M, Kalimo H, Järvinen M. Muscle injuries: biology and treatment. Am J Sports Med 2005 May; 33(5): 745-63.
23. Serner AB, Mosler JL, Tol R, Bahr R, Weir A. Mechanisms of acute adductor longus injuries in male football players: A systematic visual video analysis. Br J Sports Med 2019; 53(3): 158-63.
24. Schilders E, Bharam S, Golan E, Dimitrakopoulou A, Mitchell A, Spaepen M. The pyramidalis-anterior pubic ligament-adductor longus complex (PLAC) and its role with adductor injuries: a new anatomical concept. Knee Surg Sports Traumatol Arthrosc 2017 Dec; 25(12): 3969-77.
25. Meyers WC, McKechnie A, Philippon MJ, Horner MA, Zoga AC, Devon ON. Experi-ence with "sports hernia" spanning two decades. Ann Surg 2008 Oct; 248(4): 646-64.
26. Ellsworth M, Zoland P, Tyler MF. Invited Clinical Commentary Athletic Pubalgia and Associated. Int J Sports Phys Ther 2014; 9(8): 774-84.
27. Dimitrakopoulou A, Schilders E. Sportsman's hernia? An ambiguous term. J Hip Preserv Surg 2016 Feb 24; 3(1): 16-22.
28. Bisciotti GN, Volpi P, Zini R, Auci A, Aprato A, Belli A, Bellistri G, Benelli P, Bona S, Bonaiuti D, Carimati G, Canata GL, Cassaghi G, Cerulli S, Delle Rose G, Di Benedetto P, Di Marzo F, Di Pietto F, Felicioni L, Ferrario L, Foglia A, Galli M, Gervasi E, Gia L, Giammattei C, Guglielmi A, Marioni A, Moretti B, Niccolai R, Orgiani N, Pantalone A, Parra F, Quaglia A, Respizzi F, Ricciotti L, Pereira Ruiz MT, Russo A, Sebastiani E, Tancredi G, Tosi F, Vuckovic Z. Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete. BMJ Open Sport Exerc Med. 2016 Nov 29;2(1):e000142. doi: 10.1136/bmjsem-2016-000142. eCollection 2016. Erratum in: BMJ Open Sport Exerc Med. 2017 Jan 3;2(1):e000142corr1.
29. Zini R, Bisciotti G, Di Marzo F, Volpi P. Groin Pain Syndrome Italian Consensus. 2016; no. Mi: 1-85.
30. Roos MM, Verleisdonk EMM, Sanders FBM, Hoes AW, Stellato RK, Frederix GWJ. Effectiveness of endoscopic totally extraperitoneal (TEP) hernia correction for clinically occult inguinal hernia (EFFECT): study protocol for a randomized controlled trial. Trials 2018 Jun 18; 19(1): 322.
31. Branci S, Thorborg K, Bech BH, Boesen M, Magnussen E, Court-Payen M et al. The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes: outline and intratester and intertester reliability. Br J Sports Med 2015 May; 49(10): 692-9.
32. Brennan D, O'Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C et al. Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation. Radiology 2005 Apr; 235(1): 162-7.
33. Weir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther 2011 Apr; 16(2): 148-54.
34. Schöberl M, Prantl L, Loose O, Zellner J, Angele P, Zeman F et al. Non-surgical treatment of pubic overload and groin pain in amateur football players: a prospective double-blinded randomised controlled study. Knee Surg Sports Traumatol Arthrosc 2017 Jun; 25(6): 1958-65.
35. Hölmich P, Uhrskou P, Ulnits L, Kanstrup I, Nielsen MB, Bjerg AM. Effectiveness of active physical training as treatment for long- standing adductor-related groin pain in athletes : randomised trial. Lancet 1999; 353: 439-43.
36. R. D. de Queiroz RD, R. T. de Carvalho RT, P. R. de Queiroz Szeles PR, C. Janovsky C, and M. Cohen M. Return to sport after surgical treatment for pubalgia among professional soccer players. ReV Bras Ortop 2014; 49(3): 233-39.
37. Dojčinović B, Sebečić B, Starešinić M, Janković S, Japjec M, Čuljak V. Surgical treatment of chronic groin pain in athletes. Int Orthop 2012 Nov; 36(11): 231-5.
38. Kajetanek C, Benoît O, Granger B, Menegaux F, Chereau N, Pascal-Mousselard H et al. Athletic pubalgia: Return to play after targeted surgery. Orthop Traumatol Surg Res 2018 Jun; 104(4): 469-72.
39. Akermark C, Johansson C. Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 1992 Nov-Dec; 20(6): 630-3.
40. Bharam S, Feghhi DP, Porter DA, Bhagat PV. Proximal Adductor Avulsion Injuries: Outcomes of Surgical Reattachment in Athletes. Orthop J Sport Med 2018 Jul; 6(7): 1-6.
41. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR. Management of Severe Lower Abdominal or Inguinal Pain in High-Performance Athletes. Am J Sports Med 2000; 28(1): 2-8.
42. Muschaweck U, Berger LM. Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review. Spor. Heal. A Multidiscip. Approach. May 2010; 2(3): 216-21.
43. Sheen J, Pilkington JJ, Dudai M, Conze JK. The Vienna Statement; an Update on the Surgical Treatment of Sportsman’s Groin in 2017. Front Surg 2018; 5: 1-5.
44. Brunt LM. Surgical Treatment of Sports Hernia: Open Mesh Approach in Sports Hernia and Athletic Pubalgia, Boston, MA. Springer US, 2014: 133-42.
45. 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). Surgery2011; 150(1): 99-107.
46. Genitsaris M, Goulimaris I, Sikas N. Laparoscopic Repair of Groin Pain in Athletes. Am J Sports Med 2004; 32(5): 1238-42.
47. Lloyd DM, Sutton CD, Altafa A, Fareed K, Bloxham L, Spencer L et al. Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall: a new approach for the management of chronic groin pain. Surg Laparosc Endosc Percutan Tech 2008 Aug; 18(4): 337-8.
48. Pogliacomi F, Calderazzi F, Paterlini M, Pompili M, Ceccarelli F. Anterior iliac spines fractures in the adolescent athlete: surgical or conservative treatment? Medicina dello Sport 2013; 65(2): 231-40.
49. Calderazzi F, Nosenzo A, Galavotti C, Menozzi M, Pogliacomi F, Ceccarelli F. Apophyseal avul-sion fractures of the pelvis. A review. Acta Biomed 2018 89(4): 470-6.
50. Di Benedetto P, Niccoli G, Magnanelli S, Beltrame A, Gisonni R, Cainero V et al. Arthro-scopic treatment of iliopsoas impingement syndrome after hip arthroplasty. Acta Biomed 2019 Jan 10; 90(1-S): 104-9.
51. Pierannunzi L, Di Benedetto P, Carulli C, Fiorentino G, Munegato D, Panascì M et al. Mid-term outcome after arthroscopic treatment of femoroacetabular impingement: development of a predictive score. Hip Int 2019 May; 29(3): 303-9.
52. Di Benedetto P, Barbattini P, Povegliano L, Beltrame A, Gisonni R, Cainero V et al. Extra-capsular vs standard approach in hip arthroscopy. Acta Biomed 2016 Apr 15; 87 Suppl 1: 41-5.
53. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009 Jul 21; 339: b2700.
54. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ et al. As-sessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996 Feb; 17(1): 1-12.
55. (NHLBI) National Heart, Lung, “Study Quality Assessment Tools.” (Online). Available: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. (Accessed: 21-Jun-2019).
56. Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, Niu Y et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med 2015 Feb; 8(1): 2-10.
57. Weir CJ, Butcher I, Assi V, Lewis SC, Murray GD, Langhorne P et al. Dealing with missing standard deviation and mean values in meta analysis of continuous outcomes: a systematic review. BMC Med Res Methodol 2018 Mar 7; 18(1): 25.
58. Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14(1): 135.
59. Hölmich P, Uhrskou P, Ulnits L, Kanstrup I, Nielsen MB, Bjerg AM. Effectiveness of active physical training as treatment for long- standing adductor-related groin pain in athletes : randomised trial. Lancet 1999; 353: 439-43.
60. Weir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther 2011 Apr; 16(2): 148-54.
61. Yousefzadeh A, Shadmehr A, Olyaei GR, Naseri N, Khazaeipour Z. Effect of Holmich protocol exercise therapy on long-standing adductor related groin pain in athletes: an objective evaluation. BMJ Open Sport Exerc Med 2018 Jun 26; 4(1): e000343.
62. Yousefzadeh A1, Shadmehr A1, Olyaei GR1, Naseri N1, Khazaeipour Z2. The Effect of Therapeutic Exercise on Long-Standing Adductor Related Groin Pain in Athletes: Modified Hölmich Protocol. Rehabil Res Pract 2018 Mar; 12: :8146819..
63. Van Der Donckt K, Steenbrugge F, Van Den Abbeele K, Verdonk R, Verhelst M. Bassi-ni's hernial repair and adductor longus tenotomy in the treatment of chronic groin pain in athletes. Acta Orthop Belg 2003; 69(1): 35-41.
64. S. J. Gore SJ, E. King E, and K. Moran K. Is stiffness related to athletic groin pain?. Scand J Med Sci Sports 2018 Jun; 28(6): 1-10.
65. King E, Franklyn-Miller A, Richter C, O'Reilly E, Doolan M, Moran K et al. Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients. Br J Sports Med 2018 Aug; 52(16): 1054-62.
66. Sheen AJ, Stephenson BM, Lloyd DM, Robinson P, Fevre D, Paajanen H et al. Treat-ment of the sportsman's groin': British Hernia Society's 2014 position statement based on the Manchester Consensus Conference. Br J Sports Med 2014 Jul; 48(14): 1079-87.
2. Pogliacomi F, Costantino C, Pedrini MF, Pourjafar S, De Filippo M, Ceccarelli F. Anterior groin pain in athlete as consequence of bone diseases: aetiopathogenensis, diagnosis and principles of treatment. Medicina dello Sport 2014; 66(1): 1-27.
3. Pogliacomi F, Costantino C, Pedrini MF, Pourjafar S, De Filippo M, Ceccarelli F. Anterior groin pain in athletes as a consequence of intra-articular diseases: aetiopathogenensis, diagnosis and principles of treatment. Medicina dello Sport 2014; 66(3): 341-68.
4. Pogliacomi F, Pedrini MF, Pourjafar S, Pellegrini A, Paraskevopoulos A, Costantino C, Ceccarelli F. Pubalgia and soccer: real problem or overestimated? Medicina dello Sport 2015; 68(4): 641-62.
5. Di Benedetto P, Niccoli G, Beltrame A, Gisonni R, Cainero V, Causero A. Histopathological aspects and staging systems in non-traumatic femoral head osteonecrosis: an overview of the literature. Acta Biomed 2016 Apr 15; 87 Suppl 1: 15-24. Review.
6. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan K et al. “Doha agreement meeting on terminology and definitions in groin pain in athletes,” Br J Sports Med 2015; 49(12): 768-74.
7. Morelli V, Weaver V. Groin injuries and groin pain in athletes: Part 1 Prim. Care Clin. Off. Pract. 2005; 32(1): 137-83.
8. Bisciotti GN, Eirale C, Vuckovic Z, Le Picard P, D’Hooghe P, Chalabi H. La pubalgia dell’atleta: Una revisione della letteratura. Medicina dello Sport 2013; 65 (1): 119-33.
9. Brunt LM. Hernia Management in the Athlete. Adv Surg 2016; 50 (1): 187-202.
10. Trofa DP, Mayeux SE, Parisien RL, Ahmad CS, Lynch TS. Mastering the Physical Examination of the Athlete’s Hip. Am. J. Orthop. (Belle Mead. NJ) 2017; 46(1): 10-65.
11. de Sa D, Hölmich P, Phillips M, Heaven S1, Simunovic N, Philippon MJ. Athletic groin pain: a systematic review of surgical diagnoses, investigations and treatment. Br J Sports Med 2016 Oct; 50(19): 1181-6.
12. Anderson K, Strickland SM, Warren R. Hip and Groin Injuries in Athletes. Am. J Sports Med 2001; 29(4): 521-33.
13. Orso CA, Calabrese BF, D’Onofrio S, Passerini A. The rectus-adductor syndrome. The nosographic picture and treatment criteria. Ann. Ital. Chir 1990; 1(6): 647-9.
14. Estwanik JJ, Sloane B, Rosenberg MA. Groin Strain and Other Possible Causes of Groin Pain. Phys Sportsmed 1990 Feb;18(2):54-64.
15. Rennie W, Lloyd D. Sportsmans Groin: The Inguinal Ligament and the Lloyd Technique. J Belgian Soc Radiol 2018; 101(S2): 1-4.
16. Omar IM, Zoga AC, Kavanagh EC, Koulouris G, Bergin D, Gopez AG et al. Athletic Pubalgia and ‘Sports Hernia’:Optimal MR ImagingTechnique and Findings. RadioGraphics 2008; 28: 1415-38.
17. Riley G. The pathogenesis of tendinopathy. A molecular perspective. Rheumatology 2004; 43(2): 131-42.
18. Valent A, Frizziero A, Bressan S, Zanella E, Giannotti E, Masiero S. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review. Muscles Ligaments Tendons J 2012; 2(2): 142-8.
19. Santilli OL, Nardelli N, Santilli HA, Tripoloni DE. Sports hernias: experience in a sports medicine center. Hernia 2016; 20(1): 77-84.
20. Holmich P, Renstrom PA. Long-standing groin pain in sports people falls into three primary patterns, a ‘clinical entity’ approach: a prospective study of 207 patients * COMMENTARY. Br J Sports Med 2007; 41(4): 247-52.
21. Serner A, Tol JL, Jomaah N, Weir A, Whiteley R, Thorborg K ET AL. Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes. Am J Sports Med 2015 Aug; 43(8): 1857-63.
22. Järvinen TA, Järvinen TL, Kääriäinen M, Kalimo H, Järvinen M. Muscle injuries: biology and treatment. Am J Sports Med 2005 May; 33(5): 745-63.
23. Serner AB, Mosler JL, Tol R, Bahr R, Weir A. Mechanisms of acute adductor longus injuries in male football players: A systematic visual video analysis. Br J Sports Med 2019; 53(3): 158-63.
24. Schilders E, Bharam S, Golan E, Dimitrakopoulou A, Mitchell A, Spaepen M. The pyramidalis-anterior pubic ligament-adductor longus complex (PLAC) and its role with adductor injuries: a new anatomical concept. Knee Surg Sports Traumatol Arthrosc 2017 Dec; 25(12): 3969-77.
25. Meyers WC, McKechnie A, Philippon MJ, Horner MA, Zoga AC, Devon ON. Experi-ence with "sports hernia" spanning two decades. Ann Surg 2008 Oct; 248(4): 646-64.
26. Ellsworth M, Zoland P, Tyler MF. Invited Clinical Commentary Athletic Pubalgia and Associated. Int J Sports Phys Ther 2014; 9(8): 774-84.
27. Dimitrakopoulou A, Schilders E. Sportsman's hernia? An ambiguous term. J Hip Preserv Surg 2016 Feb 24; 3(1): 16-22.
28. Bisciotti GN, Volpi P, Zini R, Auci A, Aprato A, Belli A, Bellistri G, Benelli P, Bona S, Bonaiuti D, Carimati G, Canata GL, Cassaghi G, Cerulli S, Delle Rose G, Di Benedetto P, Di Marzo F, Di Pietto F, Felicioni L, Ferrario L, Foglia A, Galli M, Gervasi E, Gia L, Giammattei C, Guglielmi A, Marioni A, Moretti B, Niccolai R, Orgiani N, Pantalone A, Parra F, Quaglia A, Respizzi F, Ricciotti L, Pereira Ruiz MT, Russo A, Sebastiani E, Tancredi G, Tosi F, Vuckovic Z. Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete. BMJ Open Sport Exerc Med. 2016 Nov 29;2(1):e000142. doi: 10.1136/bmjsem-2016-000142. eCollection 2016. Erratum in: BMJ Open Sport Exerc Med. 2017 Jan 3;2(1):e000142corr1.
29. Zini R, Bisciotti G, Di Marzo F, Volpi P. Groin Pain Syndrome Italian Consensus. 2016; no. Mi: 1-85.
30. Roos MM, Verleisdonk EMM, Sanders FBM, Hoes AW, Stellato RK, Frederix GWJ. Effectiveness of endoscopic totally extraperitoneal (TEP) hernia correction for clinically occult inguinal hernia (EFFECT): study protocol for a randomized controlled trial. Trials 2018 Jun 18; 19(1): 322.
31. Branci S, Thorborg K, Bech BH, Boesen M, Magnussen E, Court-Payen M et al. The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes: outline and intratester and intertester reliability. Br J Sports Med 2015 May; 49(10): 692-9.
32. Brennan D, O'Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C et al. Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation. Radiology 2005 Apr; 235(1): 162-7.
33. Weir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther 2011 Apr; 16(2): 148-54.
34. Schöberl M, Prantl L, Loose O, Zellner J, Angele P, Zeman F et al. Non-surgical treatment of pubic overload and groin pain in amateur football players: a prospective double-blinded randomised controlled study. Knee Surg Sports Traumatol Arthrosc 2017 Jun; 25(6): 1958-65.
35. Hölmich P, Uhrskou P, Ulnits L, Kanstrup I, Nielsen MB, Bjerg AM. Effectiveness of active physical training as treatment for long- standing adductor-related groin pain in athletes : randomised trial. Lancet 1999; 353: 439-43.
36. R. D. de Queiroz RD, R. T. de Carvalho RT, P. R. de Queiroz Szeles PR, C. Janovsky C, and M. Cohen M. Return to sport after surgical treatment for pubalgia among professional soccer players. ReV Bras Ortop 2014; 49(3): 233-39.
37. Dojčinović B, Sebečić B, Starešinić M, Janković S, Japjec M, Čuljak V. Surgical treatment of chronic groin pain in athletes. Int Orthop 2012 Nov; 36(11): 231-5.
38. Kajetanek C, Benoît O, Granger B, Menegaux F, Chereau N, Pascal-Mousselard H et al. Athletic pubalgia: Return to play after targeted surgery. Orthop Traumatol Surg Res 2018 Jun; 104(4): 469-72.
39. Akermark C, Johansson C. Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 1992 Nov-Dec; 20(6): 630-3.
40. Bharam S, Feghhi DP, Porter DA, Bhagat PV. Proximal Adductor Avulsion Injuries: Outcomes of Surgical Reattachment in Athletes. Orthop J Sport Med 2018 Jul; 6(7): 1-6.
41. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR. Management of Severe Lower Abdominal or Inguinal Pain in High-Performance Athletes. Am J Sports Med 2000; 28(1): 2-8.
42. Muschaweck U, Berger LM. Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review. Spor. Heal. A Multidiscip. Approach. May 2010; 2(3): 216-21.
43. Sheen J, Pilkington JJ, Dudai M, Conze JK. The Vienna Statement; an Update on the Surgical Treatment of Sportsman’s Groin in 2017. Front Surg 2018; 5: 1-5.
44. Brunt LM. Surgical Treatment of Sports Hernia: Open Mesh Approach in Sports Hernia and Athletic Pubalgia, Boston, MA. Springer US, 2014: 133-42.
45. 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). Surgery2011; 150(1): 99-107.
46. Genitsaris M, Goulimaris I, Sikas N. Laparoscopic Repair of Groin Pain in Athletes. Am J Sports Med 2004; 32(5): 1238-42.
47. Lloyd DM, Sutton CD, Altafa A, Fareed K, Bloxham L, Spencer L et al. Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall: a new approach for the management of chronic groin pain. Surg Laparosc Endosc Percutan Tech 2008 Aug; 18(4): 337-8.
48. Pogliacomi F, Calderazzi F, Paterlini M, Pompili M, Ceccarelli F. Anterior iliac spines fractures in the adolescent athlete: surgical or conservative treatment? Medicina dello Sport 2013; 65(2): 231-40.
49. Calderazzi F, Nosenzo A, Galavotti C, Menozzi M, Pogliacomi F, Ceccarelli F. Apophyseal avul-sion fractures of the pelvis. A review. Acta Biomed 2018 89(4): 470-6.
50. Di Benedetto P, Niccoli G, Magnanelli S, Beltrame A, Gisonni R, Cainero V et al. Arthro-scopic treatment of iliopsoas impingement syndrome after hip arthroplasty. Acta Biomed 2019 Jan 10; 90(1-S): 104-9.
51. Pierannunzi L, Di Benedetto P, Carulli C, Fiorentino G, Munegato D, Panascì M et al. Mid-term outcome after arthroscopic treatment of femoroacetabular impingement: development of a predictive score. Hip Int 2019 May; 29(3): 303-9.
52. Di Benedetto P, Barbattini P, Povegliano L, Beltrame A, Gisonni R, Cainero V et al. Extra-capsular vs standard approach in hip arthroscopy. Acta Biomed 2016 Apr 15; 87 Suppl 1: 41-5.
53. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009 Jul 21; 339: b2700.
54. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ et al. As-sessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996 Feb; 17(1): 1-12.
55. (NHLBI) National Heart, Lung, “Study Quality Assessment Tools.” (Online). Available: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. (Accessed: 21-Jun-2019).
56. Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, Niu Y et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med 2015 Feb; 8(1): 2-10.
57. Weir CJ, Butcher I, Assi V, Lewis SC, Murray GD, Langhorne P et al. Dealing with missing standard deviation and mean values in meta analysis of continuous outcomes: a systematic review. BMC Med Res Methodol 2018 Mar 7; 18(1): 25.
58. Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14(1): 135.
59. Hölmich P, Uhrskou P, Ulnits L, Kanstrup I, Nielsen MB, Bjerg AM. Effectiveness of active physical training as treatment for long- standing adductor-related groin pain in athletes : randomised trial. Lancet 1999; 353: 439-43.
60. Weir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther 2011 Apr; 16(2): 148-54.
61. Yousefzadeh A, Shadmehr A, Olyaei GR, Naseri N, Khazaeipour Z. Effect of Holmich protocol exercise therapy on long-standing adductor related groin pain in athletes: an objective evaluation. BMJ Open Sport Exerc Med 2018 Jun 26; 4(1): e000343.
62. Yousefzadeh A1, Shadmehr A1, Olyaei GR1, Naseri N1, Khazaeipour Z2. The Effect of Therapeutic Exercise on Long-Standing Adductor Related Groin Pain in Athletes: Modified Hölmich Protocol. Rehabil Res Pract 2018 Mar; 12: :8146819..
63. Van Der Donckt K, Steenbrugge F, Van Den Abbeele K, Verdonk R, Verhelst M. Bassi-ni's hernial repair and adductor longus tenotomy in the treatment of chronic groin pain in athletes. Acta Orthop Belg 2003; 69(1): 35-41.
64. S. J. Gore SJ, E. King E, and K. Moran K. Is stiffness related to athletic groin pain?. Scand J Med Sci Sports 2018 Jun; 28(6): 1-10.
65. King E, Franklyn-Miller A, Richter C, O'Reilly E, Doolan M, Moran K et al. Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients. Br J Sports Med 2018 Aug; 52(16): 1054-62.
66. Sheen AJ, Stephenson BM, Lloyd DM, Robinson P, Fevre D, Paajanen H et al. Treat-ment of the sportsman's groin': British Hernia Society's 2014 position statement based on the Manchester Consensus Conference. Br J Sports Med 2014 Jul; 48(14): 1079-87.
Downloads
Published
05-12-2019
Issue
Section
REVIEWS
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
1.
Bastia P, Ghirarduzzi P, Schiavi P, et al. Surgical or conservative treatment in ARGP syndrome? A systematic review . Acta Biomed. 2019;90(12-S):14-24. doi:10.23750/abm.v90i12-S.8962
