Research Article
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Year 2023, Volume: 14 Issue: 2, 155 - 160, 17.03.2023

Ali Eraslan

https://doi.org/10.31067/acusaglik.1174274

Abstract

Supporting Institution

Yok

Project Number

Yok

Thanks

Yok

References

  • 1. Davies AG, Clarke AW, Gilmore J, Wotherspoon M, Connell DA. Imaging of groin pain in the athlete. Skeletal Radiol. 2010;39:629-644. DOI: 10.1007/s00256-009-0768-9
  • 2. 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
  • 3. Van Beijsterveldt AM, Steffen K, Stubbe JH, Frederiks JE, van de Port IG, Backx FJ. Soccer injuries and recovery in Dutch male amateur soccer players: results of a prospective cohort study. Clin J Sport Med. 2014;24:337-342. DOI: 10.1097/JSM.0000000000000028
  • 4. Werner J, Hägglund M, Ekstrand J, Waldén M. Hip and groin time-loss injuries decreased slightly but injury burden remained constant in men’s professional football: the 15-year prospective UEFA Elite Club Injury Study. Br J Sports Med. 2019;53:539-546. DOI: 10.1136/bjsports-2017-097796
  • 5. Slavotinek JP, Verrall GM, Fon GT, Sage MR. Groin pain in footballers: the association between preseason clinical and pubic bone magnetic resonance imaging findings and athlete outcome. Am J Sports Med. 2005;33:894-899. DOI: 10.1177/0363546504271206
  • 6. Albers SL, Spritzer CE, Garrett WE Jr, Meyers WC. MR findings in athletes with pubalgia. Skeletal Radiol. 2001;30:270-277. DOI: 10.1007/s002560100335
  • 7. Verrall GM, Slavotinek JP, Fon GT. Incidence of pubic bone marrow oedema in Australian rules football players: relation to groin pain. Br J Sports Med. 2001;35:28-33. DOI: 10.1136/bjsm.35.1.28
  • 8. Cunningham PM, Brennan D, O'Connell M, MacMahon P, O'Neill P, Eustace S. Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI. Am J Roentgenol. 2007;188:W291-296. DOI: 10.2214/AJR.06.0051
  • 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
  • 10. 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
  • 11. Kuikka L, Hermunen H, Paajanen H. Effect of pubic bone marrow edema on recovery from endoscopic surgery for athletic pubalgia. Scand J Med Sci Sports. 2015;25:98-103. DOI: 10.1111/sms.12158
  • 12. 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;25:1958-1966. DOI: 10.1007/s00167-017-4423-z
  • 13. Verrall GM, Henry L, Fazzalari NL, Slavotinek JP, Oakeshott RD. Bone biopsy of the parasymphyseal pubic bone region in athletes with chronic groin injury demonstrates new woven bone formation consistent with a diagnosis of pubic bone stress injury. Am J Sports Med. 2008;36:2425-2431. DOI: 10.1177/0363546508324690
  • 14. Muschaweck U, Berger LM. Sportsmen's Groin-Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review. Sports Health. 2010;2:216-221. DOI: 10.1177/1941738110367623
  • 15. Orchard JW, Read JW, Neophyton J, Garlick D. Groin pain associated with ultrasound finding of inguinal canal posterior wall deficiency in Australian Rules footballers. Br J Sports Med. 1998;32:134-139. DOI: 10.1136/bjsm.32.2.134
  • 16. Harmon KG. Evaluation of groin pain in athletes. Curr Sports Med Rep. 2007;6:354-361. DOI: 10.1097/01.CSMR.0000305612.13543.b0
  • 17. Bradley M, Morgan D, Pentlow B, Roe A. The groin hernia - an ultrasound diagnosis? Ann R Coll Surg Engl. 2003;85:178-180. DOI: 10.1308/003588403321661334
  • 18. Vasileff WK, Nekhline M, Kolowich PA, Talpos GB, Eyler WR, van Holsbeeck M. Inguinal Hernia in Athletes: Role of Dynamic Ultrasound. Sports Health. 2017;9:414-421. DOI: 10.1177/1941738117717009
  • 19. 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
  • 20. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995;27:76-79.
  • 21. Thorborg K, Couppe C, Petersen J, Magnusson SP, Holmich P. Eccentric hip adduction and abduction strength in elite soccer players and matched controls: A cross-sectional study. Br J Sports Med. 2011;45:10-13. DOI: 10.1136/bjsm.2009.061762
  • 22. Griffin VC, Everett T, Horsley IG. A comparison of hip adduction to abduction strength ratios, in the dominant and non-dominant limb, of elite academy football players. J Biomed Eng Inform. 2016;2:109-118. DOI: 10.5430/jbei.v2n1p109
  • 23. Idoate F, Calbet JAL, Izquierdo M, Sanchis-Moysi J. Soccer Attenuates the Asymmetry of Rectus Abdominis Muscle Observed in Non-Athletes. PLoS One. 2011;6:e19022. DOI: 10.1371/journal.pone.0019022
  • 24. Ugwu A, Khan KS, Chow K. Accuracy of Ultrasound as a Diagnostic Tool for the Assessment of Occult Groin Hernias. J Surg. 2020;8:38-42. DOI: 10.11648/j.js.201200801.18

Is Groin Hernia Associated with Pubic Edema Severity in Footballers?

Year 2023, Volume: 14 Issue: 2, 155 - 160, 17.03.2023

Ali Eraslan

https://doi.org/10.31067/acusaglik.1174274

Abstract

Objective: The groin area, with its complex anatomical structure, can have different athletic problems simultaneously. In this study, it was aimed to investigate whether groin hernia had a relationship with pubic bone marrow edema (BME) severity in footballers.

Method: Among the athletes with painful groin from different sports, only male footballers who had pubic BME in pelvic MRI report were included in the study. The included athletes underwent a second archive scan for groin hernia (hernia symptoms, previous hernia surgery, sonography report). Then, the MRI sections of hernia-related cases were re-evaluated. For this purpose, right and left pubic BME signal intensities (SI) were quantitatively measured using "region of interest (ROI)" program module on T2 fat-suppressed images.

Results: A total of 93 footballers with pubic BME were found. Eleven of them (11.8%) had a concurrent hernia, while five (5.4%) had a repaired hernia prior to study. ROI measurements of these sixteen athletes revealed that the pubic bones on the side of concurrent and repaired hernia had a significantly greater mean BME intensity than opposite pubic bones (1049 SI versus 796 SI, p<0.001).

Conclusion: A groin hernia can be seen concurrently in one-tenth of footballers with pubic BME. Whether the hernia is concurrent or repaired, its side overlaps with the side of serious pubic BME. There is significant association between hernia and pubic BME severity in terms of groin selection. Strength / flexibility imbalance between the groin sides or leg dominancy can be research subject in this context.

Keywords

Football Athlete Groin Hernia Bone Marrow Edema

Project Number

Yok

References

  • 1. Davies AG, Clarke AW, Gilmore J, Wotherspoon M, Connell DA. Imaging of groin pain in the athlete. Skeletal Radiol. 2010;39:629-644. DOI: 10.1007/s00256-009-0768-9
  • 2. 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
  • 3. Van Beijsterveldt AM, Steffen K, Stubbe JH, Frederiks JE, van de Port IG, Backx FJ. Soccer injuries and recovery in Dutch male amateur soccer players: results of a prospective cohort study. Clin J Sport Med. 2014;24:337-342. DOI: 10.1097/JSM.0000000000000028
  • 4. Werner J, Hägglund M, Ekstrand J, Waldén M. Hip and groin time-loss injuries decreased slightly but injury burden remained constant in men’s professional football: the 15-year prospective UEFA Elite Club Injury Study. Br J Sports Med. 2019;53:539-546. DOI: 10.1136/bjsports-2017-097796
  • 5. Slavotinek JP, Verrall GM, Fon GT, Sage MR. Groin pain in footballers: the association between preseason clinical and pubic bone magnetic resonance imaging findings and athlete outcome. Am J Sports Med. 2005;33:894-899. DOI: 10.1177/0363546504271206
  • 6. Albers SL, Spritzer CE, Garrett WE Jr, Meyers WC. MR findings in athletes with pubalgia. Skeletal Radiol. 2001;30:270-277. DOI: 10.1007/s002560100335
  • 7. Verrall GM, Slavotinek JP, Fon GT. Incidence of pubic bone marrow oedema in Australian rules football players: relation to groin pain. Br J Sports Med. 2001;35:28-33. DOI: 10.1136/bjsm.35.1.28
  • 8. Cunningham PM, Brennan D, O'Connell M, MacMahon P, O'Neill P, Eustace S. Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI. Am J Roentgenol. 2007;188:W291-296. DOI: 10.2214/AJR.06.0051
  • 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
  • 10. 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
  • 11. Kuikka L, Hermunen H, Paajanen H. Effect of pubic bone marrow edema on recovery from endoscopic surgery for athletic pubalgia. Scand J Med Sci Sports. 2015;25:98-103. DOI: 10.1111/sms.12158
  • 12. 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;25:1958-1966. DOI: 10.1007/s00167-017-4423-z
  • 13. Verrall GM, Henry L, Fazzalari NL, Slavotinek JP, Oakeshott RD. Bone biopsy of the parasymphyseal pubic bone region in athletes with chronic groin injury demonstrates new woven bone formation consistent with a diagnosis of pubic bone stress injury. Am J Sports Med. 2008;36:2425-2431. DOI: 10.1177/0363546508324690
  • 14. Muschaweck U, Berger LM. Sportsmen's Groin-Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review. Sports Health. 2010;2:216-221. DOI: 10.1177/1941738110367623
  • 15. Orchard JW, Read JW, Neophyton J, Garlick D. Groin pain associated with ultrasound finding of inguinal canal posterior wall deficiency in Australian Rules footballers. Br J Sports Med. 1998;32:134-139. DOI: 10.1136/bjsm.32.2.134
  • 16. Harmon KG. Evaluation of groin pain in athletes. Curr Sports Med Rep. 2007;6:354-361. DOI: 10.1097/01.CSMR.0000305612.13543.b0
  • 17. Bradley M, Morgan D, Pentlow B, Roe A. The groin hernia - an ultrasound diagnosis? Ann R Coll Surg Engl. 2003;85:178-180. DOI: 10.1308/003588403321661334
  • 18. Vasileff WK, Nekhline M, Kolowich PA, Talpos GB, Eyler WR, van Holsbeeck M. Inguinal Hernia in Athletes: Role of Dynamic Ultrasound. Sports Health. 2017;9:414-421. DOI: 10.1177/1941738117717009
  • 19. 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
  • 20. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995;27:76-79.
  • 21. Thorborg K, Couppe C, Petersen J, Magnusson SP, Holmich P. Eccentric hip adduction and abduction strength in elite soccer players and matched controls: A cross-sectional study. Br J Sports Med. 2011;45:10-13. DOI: 10.1136/bjsm.2009.061762
  • 22. Griffin VC, Everett T, Horsley IG. A comparison of hip adduction to abduction strength ratios, in the dominant and non-dominant limb, of elite academy football players. J Biomed Eng Inform. 2016;2:109-118. DOI: 10.5430/jbei.v2n1p109
  • 23. Idoate F, Calbet JAL, Izquierdo M, Sanchis-Moysi J. Soccer Attenuates the Asymmetry of Rectus Abdominis Muscle Observed in Non-Athletes. PLoS One. 2011;6:e19022. DOI: 10.1371/journal.pone.0019022
  • 24. Ugwu A, Khan KS, Chow K. Accuracy of Ultrasound as a Diagnostic Tool for the Assessment of Occult Groin Hernias. J Surg. 2020;8:38-42. DOI: 10.11648/j.js.201200801.18
There are 24 citations in total.

Details

Primary Language English
Subjects Sports Medicine
Journal Section Research Article
Authors

Ali Eraslan 0000-0001-6909-8198

Project Number Yok
Publication Date March 17, 2023
Submission Date September 13, 2022
Published in Issue Year 2023Volume: 14 Issue: 2

Cite

EndNote Eraslan A (March 1, 2023) Is Groin Hernia Associated with Pubic Edema Severity in Footballers?. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 14 2 155–160.
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