Surgical versus conservative management of traumatic proximal adductor longus avulsion injuries: A systematic review.


Journal

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
ISSN: 1479-666X
Titre abrégé: Surgeon
Pays: Scotland
ID NLM: 101168329

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 26 10 2020
revised: 05 01 2021
accepted: 27 01 2021
pubmed: 12 3 2021
medline: 9 3 2022
entrez: 11 3 2021
Statut: ppublish

Résumé

Proximal avulsion injuries of the adductor longus have been managed both conservatively and operatively with good clinical outcomes, but there is no consensus on which option yields the best results. Thus, the present study aimed to review the available literature, comparing the outcomes and the time to return to sports with different management options. This study was conducted according to the PRISMA statement. The literature search was conducted in September 2020. All the clinical trials investigating the management of traumatic proximal adductor longus avulsion injuries were considered for inclusion. Only studies reporting data from athletes were considered. The outcomes of interest were the time to return to sport and return to preinjury activity level. Data from 46 patients were retrieved. The mean follow-up was 24.6 ± 23.8 months. The study population was represented by male athletes with a mean age of 30.0 ± 4.8. Mean stump retraction was 3.3 ± 0.6 cm in the surgical and 1.7 ± 0.6 in the conservative cohort (P = 0.07). The rate of patients returning to prior activity level was similar in the two groups, but surgically treated patients required a longer time to return to sport (3.9 ± 1.5 months vs. 2.2 ± 1.0 months, P = 0.0001). Conservative management for traumatic avulsion of the proximal adductor longus insertion may produce shorter time to return to sport. Both conservative and operative strategies allowed to achieve similar pre-injury activity level. IV, systematic review.

Sections du résumé

BACKGROUND BACKGROUND
Proximal avulsion injuries of the adductor longus have been managed both conservatively and operatively with good clinical outcomes, but there is no consensus on which option yields the best results. Thus, the present study aimed to review the available literature, comparing the outcomes and the time to return to sports with different management options.
MATERIAL AND METHODS METHODS
This study was conducted according to the PRISMA statement. The literature search was conducted in September 2020. All the clinical trials investigating the management of traumatic proximal adductor longus avulsion injuries were considered for inclusion. Only studies reporting data from athletes were considered. The outcomes of interest were the time to return to sport and return to preinjury activity level.
RESULTS RESULTS
Data from 46 patients were retrieved. The mean follow-up was 24.6 ± 23.8 months. The study population was represented by male athletes with a mean age of 30.0 ± 4.8. Mean stump retraction was 3.3 ± 0.6 cm in the surgical and 1.7 ± 0.6 in the conservative cohort (P = 0.07). The rate of patients returning to prior activity level was similar in the two groups, but surgically treated patients required a longer time to return to sport (3.9 ± 1.5 months vs. 2.2 ± 1.0 months, P = 0.0001).
CONCLUSION CONCLUSIONS
Conservative management for traumatic avulsion of the proximal adductor longus insertion may produce shorter time to return to sport. Both conservative and operative strategies allowed to achieve similar pre-injury activity level.
LEVEL OF EVIDENCE METHODS
IV, systematic review.

Identifiants

pubmed: 33692004
pii: S1479-666X(21)00036-6
doi: 10.1016/j.surge.2021.01.015
pii:
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

123-128

Informations de copyright

Copyright © 2021 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Filippo Migliorini (F)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany. Electronic address: migliorini.md@gmail.com.

Nicola Maffulli (N)

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi SA, Italy; School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England, UK; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England, UK. Electronic address: n.maffulli@qmul.ac.uk.

Jörg Eschweiler (J)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany. Electronic address: joeschweiler@ukaachen.de.

Markus Tingart (M)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany. Electronic address: mtingart@ukaachen.de.

Alice Baroncini (A)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany. Electronic address: alice.baroncini@gmail.com.

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