Table 1 Open repairs for sports hernias
StudyTypePatients (M/F)Primary sportRepairMeshOperative findingsFollow-upClinical outcomes
Gilmore2R1200 (1176/24)SoccerOpenNoneTransversalis defect and separation from conjoined tendonNot specified97% returned to full activity in 6 weeks
Meyers et al13P157 (157/0)Soccer (46%), hockey (17%) football (13%)Open pelvic floor repair, (reattachment of the inferolateral edge of rectus abdominis muscle with its fascial attachment to the pubis and adjacent anterior ligament. 23% also had adductor releaseNone(1) Loose inguinal floor (57%); (2) external oblique aponeurosis defect (48%); (3) “thin” rectus abdominis muscle insertion (17%)3.9 years (range 25 to 144 months)96% returned to full activity in minimum of 6 months
Malycha & Lovell4P50 (NR)SoccerOpen reinforcement of posterior inguinal wall in two layers using prolene sutureNone(1) Bulge of posterior inguinal wall (80%); (2) no abnormalities (14%); (3) small indirect inguinal hernia (2%); (4) lipoma of spermatic cord (2%); (5) posterior inguinal wall scarring (2%)6 months93% returned to full activity in 6–8 weeks
Kumar et al30R35 (34/1)SoccerApproximation of external oblique aponeurosis and prolene darn or LichensteinYes(1) Tear in external oblique aponeurosis with or without posterior inguinal canal wall bulge (57%); (2) posterior inguinal wall bulge (28%); (3) conjoined tendon tear with dilated superficial inguinal ring (9%); (4) small direct hernia (3%); (5) lipoma of spermatic cord with posterior inguinal wall bulge (3%)6 months93% returned to full activity in mean 14 weeks
Steele et al87R47 (47/0)Soccer or rugbyModified Bassini with meshYesBulging of posterior inguinal wall6–50 months77% returned to full activity in 4 months
Hackney47R15 (14/1)SoccerParainguinal approach, reconstitution of internal ring, plication of transversalis fasciaNoneWeakening of transversalis fascia with separation from conjoined tendon and dilatation of the internal ring (100%), as above with a direct inguinal hernia (7%)18–60 months87% returned to full activity in 6 weeks
Polglase et al97R64 (62/2)Australian Rules footballStandard Bassini and Tanner Slide or plication of transversalis fasciaNone1) Deranged posterior wall of inguinal canal (85%); (2) splitting of conjoined tendon (26%); (3) indirect inguinal hernia (8%)8 months62.5% returned to full activity; 31% partially satisfied; 4.7% dissatisfied at minimum of 8 months post-surgery
Brannigan et al37R85 (NR)SoccerModified ShouldiceNone1) Separation of conjoined tendon from inguinal ligament; (2) weakened transversalis fascia3–21 months96% returned to full activity in 15 weeks
Williams & Foster28R6 (6/0)Soccer (n = 4), rugby (n = 1), cricket (n = 1)Approximate external oblique aponeurosisNoneSmall external oblique aponeurosis tear at the site of emergence of the terminal branch of iliohypogastric neurovascular bundle.1.5 months100% returned to full activity in 6 weeks
Joesting21R45 (NR)Not describedModified LichtensteinYesTransversalis fascia tear12 months90% returned to full activity (time period not reported)
Taylor et al15R9 (7/2)Soccer (n = 3), baseball (n = 2), runners (n = 2), basketball (n = 1), football (n = 1)Modified BassiniNone1) Direct inguinal hernia (56%); (2) direct or indirect hernia (22%); (3) indirect inguinal hernia (11%); (4) avulsion of internal oblique aponeurosis from pubic tubercle (11%)3 months100% returned to full activity in approximately 12 weeks
Irshad et al34R22 (22/0)Ice hockeyApproximate external oblique, ablate ilioinguinal nerve86%External oblique aponeurosis tear with ilioinguinal nerve branches within the defect31 months100% returned to full activity (time period not reported)
Ahumada et al104R12 (11/1)Running (n = 4), basketball (n = 3), soccer (n = 2), football (n = 2), baseball (n = 1)Open repair with internal oblique muscle flap. Four patients also had adductor release75%Nonspecific inguinal floor attenuation and cord lipomasMedian 4 months (range 2 to 13)100% returned to sports; 83.3% excellent, 16.7% satisfactory results at approximately 6 months
Simonet et al98R10 (10/0)Ice hockeyBassini approximation70%Tears at the floor of the inguinal ring6 to 48 months100% returned to hockey with symptom improvement (time period not reported)
Van Der Donckt et al55P41 (41/0)Bassini repair and percutaneous adductor tenotomy, 14 bilateralNoneNot describedMean follow-up was 150 months (range 37 to 197)90% return to full activity in 6–15 months
Biedert et al33R24 (24/0)Soccer (n = 17), ice hockey (n = 3), others (n = 3)Open, spreading of the lateral border of the sheath of the rectus abdominius and adductor release, denervation of rectus insertionNoneNot describedMean follow-up was 6.6 years (range 1.2 to 12.3)96% returned to full activity in 3–4 months
Ziprin et al49R25 (25/0)Rugby or Soccer (n = 19), others (n = 6)Inguinal approach and exploration, repair of external oblique aponeurosis, neurolysis of iliohypogastric nerveNoneSingle or multiple tears (1–4 cm) in the external oblique aponeurosis at the sites of perforating neurovascular bundles; occult indirect hernia in 1 patient; patent processus vaginalis in 1 patient20.6 months (range 7 to 56 months)100% returned to sports. 32% continued to have mild pain. 1 patient did not improve. Mean resumption of sports was 11.6 weeks (range 4 to 20 weeks)
  • F, female; M, male; NR, not reported; P, prospective; R, retrospective.