Sports Hernia in National Hockey League Players: Does Surgery Affect Performance?

Department of Orthopaedic Surgery, Drexel College of Medicine, Philadelphia, Pennsylvania.
The American Journal of Sports Medicine (Impact Factor: 4.36). 10/2012; 41(1). DOI: 10.1177/0363546512462679
Source: PubMed


BACKGROUND:Athletic pubalgia is a complex injury that results in loss of play in competitive athletes, especially hockey players. The number of reported sports hernias has been increasing, and the importance of their management is vital. There are no studies reporting whether athletes can return to play at preinjury levels. PURPOSE:The focus of this study was to evaluate the productivity of professional hockey players before an established athletic pubalgia diagnosis contrasted with the productivity after sports hernia repair. STUDY DESIGN:Cohort study; Level of evidence, 3. METHODS:Professional National Hockey League (NHL) players who were reported to have a sports hernia and who underwent surgery from 2001 to 2008 were identified. Statistics were gathered on the players' previous 2 full seasons and compared with the statistics 2 full seasons after surgery. Data concerning games played, goals, average time on ice, time of productivity, and assists were gathered. Players were divided into 3 groups: group A incorporated all players, group B were players with 6 or fewer seasons of play, and group C consisted of players with 7 or more seasons of play. A control group was chosen to compare player deterioration or improvement over a career; each player selected for the study had a corresponding control player with the same tenure in his career and position during the same years. RESULTS:Forty-three hockey players were identified to have had sports hernia repairs from 2001 to 2008; ultimately, 80% would return to play 2 or more full seasons. Group A had statistically significant decreases in games played, goals scored, and assists. Versus the control group, the decreases in games played and assists were supported. Statistical analysis showed significant decreases in games played, goals scored, assists, and average time on ice the following 2 seasons in group C, which was also seen in comparison with the control group. Group B (16 players) showed only statistical significance in games played versus the control group. CONCLUSION:Players who undergo sports hernia surgeries return to play and often perform similar to their presurgery level. Players with over 7 full seasons return but with significant decreases in their overall performance levels. Less veteran players were able to return to play without any statistical decrease in performance and are likely the best candidates for repair once incurring injury.

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    • "Outcomes after a variety of individual orthopaedic procedures have recently been well reported in a number of professional sports, including the National Football League (NFL), 3,4,23 Major League Baseball (MLB), 8,13,21 and the National Hockey League (NHL).11,19,22These players typically demonstrate high rates of return to play (RTP) and preinjury performance depending on the procedure and sport. "
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    ABSTRACT: Background: Professional basketball players have a high incidence of injuries requiring surgical intervention. However, there are no studies in the current literature that have compared postoperative performance outcomes among common injuries to determine “high” and “low” risk procedures to these athletes’ careers. Purpose: To compare return to play rates and performance-based outcomes after different orthopaedic procedures in National Basketball Association (NBA) players, and determine which surgeries are associated with the worst postoperative change in performance. Methods: Athletes in the NBA undergoing ACL reconstruction, Achilles tendon repair, lumbar discectomy, microfracture, meniscal surgery, hand/wrist or foot fracture fixation, and shoulder stabilization were identified through team injury reports and archives on public record. The return to play (RTP) rate, games played per season, and player efficiency rating (PER) were determined before and after surgery. Statistical analysis was used to compare the change between pre and postsurgical performance among the different injuries. Results: A total of 348 players were included. RTP rates were highest in patients with hand/wrist fractures (98.1%, mean age of 28.4 years) and lowest for those with Achilles tears (70.8%, mean age of 27.0 years) (p = 0.005). Increasing age (Odds Ratio 3.85) and body mass index (BMI) (Odds ratio 3.46) were predictors of not returning to play. Players undergoing Achilles tendon repair and arthroscopic knee surgery had a significantly greater decline in postoperative performance outcomes at the 1-year and 3-year time points and had shorter career lengths compared to the other procedures. Conclusion: NBA players undergoing Achilles tendon rupture repair or arthroscopic knee surgery had significantly worse performance postoperatively compared to other orthopaedic procedures.
    Full-text · Article · Oct 2015 · The American Journal of Sports Medicine
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    ABSTRACT: Adductor injuries are a common cause of chronic groin pain in athletes. This pathology is often seen in athletes participating in cutting activities such as soccer, ice hockey, football, and rugby. Physical examination is notable for tenderness over the adductor origin and pain with resisted hip adduction. It is essential to also evaluate for the presence of sports hernia, which is frequently seen with adductor tendinopathy. Nonoperative treatment consists of rest, ice, and nonsteroidal anti-inflammatory medications followed by stretching and strengthening. Surgical release of the adductor longus tendon is indicated when symptoms do not respond to a course of conservative management. Adductor tenotomy surgical technique as well as postoperative protocol is reviewed in detail. Results following adductor tenotomy have demonstrated that it is an effective treatment for chronic adductor strain in athletes. © 2014 Springer Science+Business Media New York. All rights reserved.
    No preview · Article · Dec 2013
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    ABSTRACT: Athletic pubalgia or sports hernia is a condition of chronic groin and lower abdominal pain in athletics, but can also be found in nonathletes. This chapter describes our institution's multidisciplinary approach to diagnosis and surgical technique for the repair of athletic pubalgia. © 2014 Springer Science+Business Media New York. All rights reserved.
    No preview · Chapter · Jan 2014
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