Early recovery after endoscopic totally extraperitoneal (TEP) hernia repair in athletes with inguinal disruption: A prospective cohort study.

BACKGROUND: Groin pain is a common problem in athletes which results in loss of playing time. Moreover, it can be for the cause of athletic career termination. A common cause of groin pain in athletes is inguinal disruption; pain in the groin area near the pubic tubercle were no obvious other pathology exists to explain the symptoms. Aim of this study was to evaluate the effect of endoscopic totally extraperitoneal (TEP) hernia repair in athletes with inguinal disruption. METHODS: Thirty-one athletes with chronic groin pain due to inguinal disruption, who had undergone conservative therapy without any effect, were included in this prospective cohort study. Prior to surgery patients were assessed by clinical examination, ultrasound of the inguinal region, x-ray and a radionuclide bone scan with single photon-emission computed tomography and CT (SPECT-CT). TEP hernia repair was performed and a lightweight polypropylene mesh was placed pre-peritoneally. Additionally the athletes' perception about their groin disability was assessed preoperatively and 6 weeks postoperatively by means of the Hip and Groin Outcome Score (HAGOS). The HAGOS consists of six subscales: Pain, Symptoms, Physical function in daily living, Physical function in Sport and Recreation, Participation in Physical Activities, and hip and/or groin-related Quality of Life. RESULTS: No complications occurred during and after surgery. After six weeks patients improved in all the separate subscales of the Hip and Groin Outcome Score (HAGOS). Within 6 weeks of surgery, 26 patients (84%) returned to sports activities with no or less groin pain. CONCLUSIONS: This study showed that endoscopic totally extraperitoneal (TEP) hernia repair is an effective surgical treatment of inguinal disruption in athletes with chronic groin pain.

Cross-Cultural Adaptation and Validation of the Dutch Version of the Hip and Groin Outcome Score (HAGOS-NL).

BACKGROUND: Valid and reliable questionnaires to assess hip and groin pain are lacking. The Hip and Groin Outcome Score (HAGOS) is a valid and reliable self-reported measure to assess symptoms, activity limitations, participation restrictions and quality of life of persons with hip and/or groin complaints. The purpose of this study was to translate and cross-culturally adapt the HAGOS into Dutch (HAGOS-NL), and to evaluate its internal consistency, validity and reliability. METHODS: Translation and cross-cultural adaption of the Dutch version of the HAGOS (HAGOS-NL) was performed according to international guidelines. The study population consisted of 178 adult patients who had undergone groin hernia repair surgery in the previous year. All respondents filled in the HAGOS-NL, the SF-36, and the SMFA-NL for determining construct validity of the HAGOS-NL. To determine reliability, 81 respondents filled in the HAGOS-NL after a time interval of two weeks. RESULTS: Factor analysis confirmed the original six-factor solution of the HAGOS. Internal consistency was good for all the subscales of the HAGOS-NL. High correlations were observed between the HAGOS-NL and the SF-36 and SMFA-NL, indicating good construct validity. The HAGOS-NL showed high reliability, except for the subscale Participation in Physical Activities which was moderate. CONCLUSIONS: The HAGOS was successfully translated and cross-culturally adapted from English into Dutch (HAGOS-NL). This study shows that the HAGOS-NL is a valid and reliable instrument for the assessment of functional status and health-related quality of life in patients with groin complaints.

[Ankle sprain during a volleyball game]. / Enkelverzwikking tijdens het volleyballen.

A 27-year old woman was admitted to the emergency room after her left ankle rolled inward during a volleyball game. On physical examination a bony prominence on the lateral side of the left foot was noticeable, without neurovascular injury. An X-ray (anterior-posterior view) showed a subtalar dislocation without associated fractures.