James Pilkigton
Manchester University NHS Foundation Trust, United Kingdom
Title: Totally extra-peritoneal repair for the Sportsman’s groin via ‘the Manchester Groin Repair’; A comparison of elite versus amateur athletes
Biography
Biography: James Pilkigton
Abstract
Background: Surgery has a recognised role for the treatment of the sportsman’s groin. This study hypothesises that elite athletes have a superior advantage in both pre- and post-op rehabilitation and therefore will present and resume sporting activities quicker.
Methods: A retrospective analysis was conducted of a secure database on sportsmen presenting with groin pain that underwent groin surgery via the totally extraperitoneal ‘Manchester Groin Repair’ (MGR). All data were explored via appropriate descriptive statistics and comparisons made between elite and amateur athletes using Mann-Whitney U test for continuous variables and Fisher’s exact test for categorical variables. Univariable and multivariable regression were also used to further explore association. Statistical assessment was performed with Rv3.1.1.
Results: 144 patients were included from May 2013 to date. All patients were male. The median postoperative follow-up was 40 months. The median age was 33 years (range 14 – 72). The median return to sporting activity was 4.5 weeks (range 2.0 – 16.0), with one amateur athlete being not able to return to sporting activity. 83 patients (57.6%) presented with bilateral and 61 patients (42.4%) with unilateral positive VAS scores for groin pain. 128 patients (88.9%) underwent bilateral repair. Comparing preoperative and 1 month postoperative VAS pain scores showed a significant reduction. There was no relationship between either preoperative pain scores or change in pain score (preoperative to 1 month post-operative) and the time taken to return to sporting activity. Comparing ‘elite’ versus ‘amateur’ athletes, statistically significant differences were seen in patient age (median 26 vs 40 years; p < 0.001), lead-time to clinic presentation (median 62.0 vs 111.5 days; p = 0.004), and time to return to sporting activity (4 vs 5 weeks; p = 0.019). MRI scan confirmed adductor injury in 34 patients (25.4%). There was no statistical difference in the coexistence of adductor injury between the elite and amateur groups and the presence of the injury did not prolong the return to sport of either group.
Conclusion
The Manchester Groin Repair is an effective surgical management of a sportsman’s groin. Elite athletes present significantly earlier than amateur athletes and return to sports quicker.