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Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis.

Dean K Matsuda1, Bantoo Sehgal2, Nicole A Matsuda3

  • 1DISC Sports and Spine Center, Marina del Rey, California, U.S.A.

Arthroscopy Techniques
|August 11, 2015
PubMed
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Endoscopic pubic symphysectomy offers a minimally invasive surgical option for recalcitrant osteitis pubis. This bone-conserving technique preserves stability and complements hip arthroscopy for athletes with co-occurring conditions.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Minimally Invasive Procedures

Background:

  • Osteitis pubis, a common cause of athletic pubalgia, is frequently associated with femoroacetabular impingement.
  • Traditional open surgical curettage for severe osteitis pubis can be invasive.
  • Endoscopic pubic symphysectomy has emerged as a less invasive alternative for managing refractory cases.

Purpose of the Study:

  • To demonstrate the technical aspects of endoscopic pubic symphysectomy using anterior and suprapubic portals.
  • To highlight the bone-conserving nature of the procedure, preserving key ligaments.
  • To evaluate its potential utility in treating recalcitrant osteitis pubis and osteoarthritis in athletes.

Main Methods:

  • Utilized a supine lithotomy position with anterior and suprapubic portals for endoscopic access.

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  • Performed burr resection of pubic symphyseal fibrocartilage and hyaline endplates.
  • Emphasized preservation of the posterior and arcuate ligaments during the procedure.

    • Main Results:

    • Successfully demonstrated endoscopic burr resection of the posteroinferior pubic symphysis.
    • The technique allows for bone preservation while maintaining structural stability.
    • This approach may be beneficial for athletes with osteitis pubis or osteoarthritis.

    Conclusions:

    • Endoscopic pubic symphysectomy is a minimally invasive, bone-conserving surgical option for recalcitrant osteitis pubis.
    • The procedure maintains joint stability and can be complementary to arthroscopic femoroacetabular impingement surgery.
    • This technique holds promise for broader application in athletes with combined hip and groin pathologies.