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Surgical Interventions in Hip and Pelvis Injuries

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The Hip and Pelvis in Sports Medicine and Primary Care

Abstract

Diagnosing the cause of hip pain in the athlete can be difficult, but it almost always can be accomplished with an understanding of local anatomy combined with a thorough history and physical examination. For most causes of athletic hip pain, the patient should be given a sustained trial of nonoperative treatment before surgery is considered. Femoral neck fractures and hip dislocations in the athlete require emergency treatment. Thoughtful imaging of the hip or pelvis is an important diagnostic tool that can distinguish tendon strain from avulsion, help diagnose osteitis pubis, and evaluate for tumor as a cause for pain. Adolescents with hip abnormalities commonly present themselves with knee pain. Adolescents with knee pain should have their hips evaluated.

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References

  1. Morelli V, Weaver V. Groin injuries and groin pain in athletes: part 1. Prim Care 2005; 32:163–183.

    PubMed  Google Scholar 

  2. Anderson K, Strickland SM, Warren R. Hip and groin injuries in ­athletes. Am J Sports Med 2001; 29:521–533.

    CAS  PubMed  Google Scholar 

  3. Garrett WE Jr, Safran MR, Seaber AV, et al. Biomechanical comparison of stimulated and nonstimulated skeletal muscle pulled to failure. Am J Sports Med 1987; 15:448–454.

    Article  PubMed  Google Scholar 

  4. Lynch SA, Renstrom PAFH. Groin injuries in sport: treatment strategies. Sports Med 1999; 28:137–144.

    Article  CAS  PubMed  Google Scholar 

  5. Pomeranz SJ, Heidt RS Jr. MR imaging in the prognostication of hamstring injury. Work in progress. Radiology 1993; 189:897–900.

    CAS  PubMed  Google Scholar 

  6. Brown TD, Brunet ME. Thigh. Section A. Adult thigh. In: DeLee JC, Drez D Jr, Miller MD, editors. DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice, 2nd ed. Philadelphia: WB Saunders; 2003:1481–1505.

    Google Scholar 

  7. Hughes C IV, Hasselman CT, Best TM, et al. Incomplete, intrasubstance strain injuries of the rectus femoris muscle. Am J Sports Med 1995; 23:500–506.

    Article  PubMed  Google Scholar 

  8. Martens MA, Hansen L, Mulier JC. Adductor tendinitis and musculus rectus abdominis tendopathy. Am J Sports Med 1987; 15:353–356.

    Article  CAS  PubMed  Google Scholar 

  9. Weinstein RN, Kraushaar BS, Fulkerson JP. Adductor tendinosis in a professional hockey player. Orthopedics 1998; 21:809–810.

    CAS  PubMed  Google Scholar 

  10. Akermark C, Johansson C. Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 1992; 20:640–643.

    Article  CAS  PubMed  Google Scholar 

  11. Schlonsky J, Olix ML. Functional disability following avulsion fracture of the ischial epiphysis. Report of two cases. J Bone Joint Surg 1972; 54A:641–644.

    Google Scholar 

  12. Metzmaker JN, Pappas AM. Avulsion fractures of the pelvis. Am J Sports Med 1985; 13:349–358.

    Article  CAS  PubMed  Google Scholar 

  13. Orava S, Kujala UM. Rupture of the ischial origin of the hamstring muscles. Am J Sports Med 1995; 23:702–705.

    Article  CAS  PubMed  Google Scholar 

  14. Kujala UM, Orava S, Karpakka J, et al. Ischial tuberosity apophysitis and avulsion among athletes. Int J Sports Med 1997; 18:149–155.

    Article  CAS  PubMed  Google Scholar 

  15. Spinner RJ, Atkinson JLD, Wenger DE, Stuart MJ. Tardy sciatic nerve palsy following apophyseal avulsion fracture of the ischial tuberosity. Case report. J Neurosurg 1998; 89:819–821.

    CAS  Google Scholar 

  16. Byrd JWT, Jones KS. Hip arthroscopy in athletes. Clin Sports Med 2001; 20:749–761.

    Article  CAS  PubMed  Google Scholar 

  17. Fullerton LR Jr, Snowdy HA. Femoral neck stress fractures. Am J Sports Med 1988; 16:365–377.

    Article  PubMed  Google Scholar 

  18. Johansson C, Ekenman I, Tornkvist H, Eriksson E. Stress fractures of the femoral neck in athletes. The consequence of a delay in diagnosis. Am J Sports Med 1990; 18:524–528.

    CAS  Google Scholar 

  19. Devas MB. Stress fractures of the femoral neck. J Bone Joint Surg Br 1965; 47:728–738.

    CAS  PubMed  Google Scholar 

  20. Shin AY, Morin WD, Gorman JD, et al. The superiority of magnetic resonance imaging in differentiating the cause of hip pain in endurance athletes. Am J Sports Med 1996; 24:168–176.

    Article  CAS  PubMed  Google Scholar 

  21. Visuri T, Vara A, Meurman KOM. Displaced stress fractures of the femoral neck in young male adults: a report of twelve operative cases. J Trauma 1988; 28:1562–1569.

    Article  CAS  PubMed  Google Scholar 

  22. Byrd JWT. Labral lesions: an elusive source of hip pain case reports and literature review. Arthroscopy 1996; 12:603–612.

    Article  CAS  PubMed  Google Scholar 

  23. Narvani AA, Tsiridis E, Tai CC, Thomas P. Acetabular labrum and its tears. Br J Sports Med 2003; 37:207–211.

    Article  CAS  PubMed  Google Scholar 

  24. Hase T, Ueo T. Acetabular labral tear: arthroscopic diagnosis and treatment. Arthroscopy 1999; 15:138–141.

    Article  CAS  PubMed  Google Scholar 

  25. Dorrell JH, Catterall A. The torn acetabular labrum. J Bone Joint Surg Br 1986; 68:400–403.

    CAS  PubMed  Google Scholar 

  26. Farjo LA, Glick JM, Sampson TG. Hip arthroscopy for acetabular labral tears. Arthroscopy 1999; 15:132–137.

    Article  CAS  PubMed  Google Scholar 

  27. Fitzgerald RH Jr. Acetabular labrum tears. Diagnosis and treatment. Clin Orthop Relat Res 1995; 311:60–68.

    PubMed  Google Scholar 

  28. Byrd JWT, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med 2004; 32:1668–1674.

    Article  PubMed  Google Scholar 

  29. Sampson TG. Complications of hip arthroscopy. Clin Sports Med 2001; 20:831–835.

    Article  CAS  PubMed  Google Scholar 

  30. Meyers WC, Foley DP, Garrett WE, et al. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group). Am J Sports Med 2000; 28:2–8.

    CAS  PubMed  Google Scholar 

  31. Hackney RG. The sports hernia: a cause of chronic groin pain. Br J Sports Med 1993; 27:58–62.

    Article  CAS  PubMed  Google Scholar 

  32. Taylor DC, Meyers WC, Moylan JA, et al. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia. Am J Sports Med 1991; 19:239–242.

    Article  CAS  PubMed  Google Scholar 

  33. Azurin DJ, Go LS, Schuricht A, et al. Endoscopic preperitoneal herniorrhaphy in professional athletes with groin pain. J Laparoendosc Adv Surg Tech A 1997; 7:7–12.

    Article  CAS  PubMed  Google Scholar 

  34. Gilmore J. Groin pain in the soccer athlete: fact, fiction, and treatment. Clin Sports Med 1998; 17:787–793.

    Article  CAS  PubMed  Google Scholar 

  35. White RA, Hughes MS, Burd T, et al. A new operative approach in the correction of external coxa saltans: the snapping hip. Am J Sports Med 2004; 32:1504–1508.

    Article  PubMed  Google Scholar 

  36. Glazer JL, Hosey RG. Soft-tissue injuries of the lower extremity. Prim Care 2004; 31:1005–1024.

    PubMed  Google Scholar 

  37. Jacobson T, Allen WC. Surgical correction of the snapping iliopsoas tendon. Am J Sports Med 1990; 18:470–474.

    Article  CAS  PubMed  Google Scholar 

  38. Brignall CG, Stainsby GD. The snapping hip. Treatment by Z-plasty. J Bone Joint Surg Br 1991; 73:253–254.

    CAS  PubMed  Google Scholar 

  39. Bradshaw C, McCrory P, Bell S, Brukner P. Obturator nerve entrapment. A cause of groin pain in athletes. Am J Sports Med 1997; 25:402–408.

    CAS  Google Scholar 

  40. Brukner P, Bradshaw C, McCrory P. Obturator neuropathy: a cause of exercise-related groin pain. Phys Sportsmed 1999; 27:62–73.

    Article  CAS  PubMed  Google Scholar 

  41. Miller EH, Benedict FE. Stretch of the femoral nerve in a dancer. A case report. J Bone Joint Surg 1985; 67A:315–317.

    Google Scholar 

  42. Harms BA, DeHaas DR Jr, Starling JR. Diagnosis and management of genitofemoral neuralgia. Arch Surg 1984; 119:339–341.

    CAS  PubMed  Google Scholar 

  43. Williams PH, Trzil KP. Management of meralgia paresthetica. J Neurosurg 1991; 74:76–80.

    Article  CAS  PubMed  Google Scholar 

  44. Foster MR. Piriformis syndrome. Orthopedics 2002; 25:821–825.

    PubMed  Google Scholar 

  45. Puranen J, Orava S. The hamstring syndrome. A new diagnosis of gluteal sciatic pain. Am J Sports Med 1988; 16:517–521.

    CAS  Google Scholar 

  46. Filler AG, Haynes J, Jordan SE, et al. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine 2005; 2:99–115.

    Article  PubMed  Google Scholar 

  47. Carney BT, Weinstein SL, Noble J. Long-term follow-up of slipped capital femoral epiphysis. J Bone Joint Surg Am 1991; 73:667–674.

    CAS  PubMed  Google Scholar 

  48. Eldridge JC. Slipped capital femoral epiphysis. In: Sponseller PD, editor. Orthopaedic Knowledge Update: Pediatrics 2. Rosemont (IL): American Academy of Orthopaedic Surgeons; 2002:143–152.

    Google Scholar 

  49. Waters PM, Millis MB. Hip and pelvic injuries in the young athlete. Clin Sports Med 1988; 7:513–526.

    CAS  PubMed  Google Scholar 

  50. Rossi F, Dragoni S. Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol 2001; 30:127–131.

    Article  CAS  PubMed  Google Scholar 

  51. Boyd KT, Peirce NS, Batt ME. Common hip injuries in sport. Sports Med 1997; 24:273–288.

    Article  CAS  PubMed  Google Scholar 

  52. Paletta GA Jr, Andrish JT. Injuries about the hip and pelvis in the young athlete. Clin Sports Med 1995; 14:591–628.

    PubMed  Google Scholar 

  53. Ahlfeld SK, Makley JT, Derosa GP, et al. Osteoid osteoma of the femoral neck in the young athlete. Am J Sports Med 1990; 18:271–276.

    Article  CAS  PubMed  Google Scholar 

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Wierks, C., Wilckens, J.H. (2010). Surgical Interventions in Hip and Pelvis Injuries. In: Seidenberg, P., Bowen, J. (eds) The Hip and Pelvis in Sports Medicine and Primary Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5788-7_15

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  • DOI: https://doi.org/10.1007/978-1-4419-5788-7_15

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