Adductor tenotomy in the management of groin pain in athletes

This study evaluates the efficacy of adductor longus tenotomy in athletes with chronic tendinopathy refractory to conservative management. In a retrospective case series we report our experience with 109 male athletes who underwent unilateral adductor tenotomy during the period 2000-2005, all of whom responded to a detailed questionnaire. The criterion for tenotomy was chronic adductor origin pain which prevented training or playing (Level 4), limited training or playing (Level 3), or affected performance (Level 2)and which had failed to respond to conservative management including rest, rehabilitation and/or local steroid injection. Level 1 performance is classified as optimal performance with no pain. 99 of the 109 patients (91%) reported improvement. Best results were achieved in patients with maximum discomfort preoperatively (Level 4) with 32 of 38 (84%) patients returning to Level 1 performance. In conclusion, adductor tenotomy in athletes with severely incapacitating pain (Level 3/4) which fails to respond to conservative management offers the best opportunity of returning to competitive sport.