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Study finds new method of sports hernia repair allows for quicker return to sports

Utilization of localized repair and nerve decompression allows for faster recovery.

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The new German method of localized repair and nerve decompression for sports hernia allowed athletes to return to sports activities significantly earlier than a similarly-afflicted group which underwent the more traditional modified Bassini repair, according to a recently presented study.

The findings were presented by Gregg J. Jarit, MD, at the American Orthopaedic Society for Sports Medicine Specialty Day 2010 meeting in New Orleans.

The purpose of our study was to compare the outcomes of two different surgical treatments for athletic pubalgia, Jarit said.

In contrast to the Bassini method of sports hernia repair  which involves the tightening of the entire pelvic floor  the German methods minimally invasive approach of repairing a localized area of the pelvic floor and decompressing the genital branch of the genitofemoral nerve involves tightening a smaller area of pelvic weakness.

The specific area to be repaired is located through the use of high-definition ultrasound.

Study parameters

Jarits team interviewed 16 patients who were, on average, 54 months post-modified Bassini repair. A second group of 10 patients who were an average of 10 months post-German repair were also interviewed, and the two groups were compared using independent sample t-tests with respect to Visual Analog Scores (VAS), pre- and postoperative Tegner activity scores, time to return to school or work, return to original level of competition, amount of medications currently prescribed, complications, and overall satisfaction with the procedure.

Jarit explained the difference in follow-up times by saying [the German procedure] was newer and performed more recently.

Why are they working?

Patients in the group that underwent the German repair returned to sports at an average of 4.5 weeks, which was significantly quicker when compared to the Bassini repair group, which returned at an average of 16.5 weeks. Jarit reported that patients in the German repair group felt back to normal at an average of 5 weeks, while the Bassini repair group felt normal at an average of 20 weeks.

For the surgeries that are successful, the question is: Why are they working? Jarit said. Is it the repair of the fascia, or the nerve release, or both? Determining the true cause is crucial to determining which procedure is best.

Jarit reported no significant differences in VAS, postoperative Tegner scores, or change in Tegner scores from preoperative to postoperative measurement. The German repair group returned to work more quickly than the Bassini repair group, but Jarit said the difference was not significant.

Return to the same level of sports, patient satisfaction, complications and current medications were all similar between both groups, he added.  by Robert Press