18 Groin pain – a cohort study and statistical analysis of correlations between mri findings and outcomes following fluoroscopically-guided pubic symphysis injection

Abstract

All cause groin pain is a common and debilitating morbidity for sports people, particularly involving kicking and twisting. At current many varying treatment pathways exist however efficacy of these is poorly described and data scant. To Review 70 athletes who having presented with clinically proven groin pain, underwent MRI scans and Fluoroscopically Guided Pubic Symphysis injections and track their outcomes. Between August 2012 and December 2014, 70 athletes, who had failed conservative management, underwent Fluoroscopically Guided Pubic Symphysis Injections and Pre Procedural Magnetic Resonance Imaging scans in a Specialist Tertiary Orthopaedic Referral Centre. These injections consisted of 80 mg of MethylPrednisolone and 2cc of 0.25% Bupivucaine. Patients were followed up at a mean of 13.2 months after injection and outcomes were recorded using Subjective Pain Scores, Level of Function and Return to Sport. Of the 70 patients, 3 were excluded due to underlying hip pathology, 10 were excluded due to not having pre-procedure MRIs and 2 were excluded due to incomplete follow up data. Patients undergoing Injection had 4 main outcomes on MRI – Osteitis Pubis, Adductor Tear, Mixed picture or Normal. For all cause Groin pain we demonstrated a mean improvement of 4.7 points on Subjective pain scores and of 2 functional levels. Players undergoing injection also returned to sport on average between 2–4 weeks post procedure. This evidence demonstrated the efficacy of pubic symphysis injections in the Treatment pathway of Athletes experiencing groin dysfunction.