Abstract
Chronic groin pain in the athlete is a common and frustrating problem that occurs most frequently in sports such as soccer, football, and hockey, which involve kicking, twisting, or rapid change of direction at speed. The differential diagnosis for athletic pubalgia is broad and includes osteitis pubis, adductor strain, iliopsoas bursitis, stress fractures, labral tears of the hip, and sports hernias. Sports hernias usually present as insidious chronic groin pain that intensifies with activity and is relieved with rest. Magnetic resonance imaging (MRI) is the most helpful imaging modality for ruling out other etiologies, but is often normal in patients with sports hernias. Initial management involves nonsteroidal anti-inflammatory drugs (NSAIDS), physical therapy, and rest. For athletes who fail conservative therapy, surgical intervention may be effective. This chapter describes an athlete with athletic pubalgia who was managed successfully with laparoscopic mesh reinforcement of the groin, and reviews the surgical options and anticipated outcomes for these challenging patients.
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