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The next step towards rational treatment for ‘The sportsman's groin’
  1. Aali J Sheen1,
  2. Hannu Paajanen2
  1. 1Department of Hernia Surgery, University of Manchester, Central Manchester Foundation NHS Trust, Manchester, UK
  2. 2Department of Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
  1. Correspondence to Aali J Sheen, Department of Hernia Surgery, University of Manchester, Central Manchester Foundation NHS Trust, Oxford Road, Manchester M13 9WL, UK; aali.sheen{at}cmft.nhs.uk

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It is well recognised that for over three decades the aetiology, whether of hip or adductor, or groin related, and subsequent management, whether surgical or otherwise, of ‘sportsman's groin’ remains mainly controversial with the literature reporting mainly case series with a few randomised trials comparing differing treatment modalities and offering some anecdotal evidence. Eventually, in 2014, the world's first consensus statement was published, which has bravely attempted to define a condition where no true hernia exists but that is a perceived repetitive strain injury causing inguinal pain and/or disruption.1

The literature to date does report some prospective randomised data on open and laparoscopic surgical results, in comparison to active physiotherapy and other conservative measures, however, there are few high-quality studies, as reported by Serner et al, with surgery not figuring high on the treatment agenda.2–4

Some of these trials do, however, appear to demonstrate a distinct leaning towards surgical repair of the disrupted groin and associated chronic pain as the treatment of choice. The surgical repair technique used, though, has largely been an example on the expertise available in the respective units carrying out such repairs. This rationale is ever apparent, as no real study from any ‘sports groin’ unit has reported on more than one type of procedure being undertaken for inguinal-related groin pain or …

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