Operative Treatment of Acute-On-Chronic Partial Adductor Longus Tendon Rupture

Jussi Kosola 1,2,
Niklas Lindblad 3,
Kimmo Mattila 4,
Lasse Lempainen 2,5,6*

1 Department of Orthopaedics and Traumatology, Helsinki University Hospital, Finland
2 Department of Physical Activity and Health, University of Turku, Finland
3 Terveystalo Sports Clinic, Turku, Finland
4 Medical Imaging Centre of Southwest Finland, Finland
5 Hospital Neo, Turku, Finland
6 Department of Surgery, Turunmaa Hospital,

Abstract

Aim: Adductor muscle strains are common injuries in contact related sports such as ice hockey and football. Most of these injuries are treated conservative with good results. However, there is no consensus on the best treatment of partial ruptures of the adductor longus tendon among athletes as non-operative and operative therapies seems both provide good results. Non-operative therapy rests on physiotherapy and operative treatment on tenotomy. MRI is an effective tool for grading the injury and is widely used for the initial diagnostics of an adductor longus injury.

Methods: A31-year old professional ice hockey player sustained a partial rupture of the adductor longus tendon which did not heal by physiotherapy. Surgery was undertaken 20 weeks after primary injury, and 16 weeks later he returned to play (RTP) successfully with no relapse during 52 weeks of follow-up. He was followed up with a series of MRI and hip strength tests during recovery from non-operative and operative treatment. MRI showed that conservative means did not provide healing, while tenotomy was curative. The strength of hip adduction of the injured side returned to the same level as the contra lateral side after surgery.

Conclusions: There may be clear benefits of tenotomy to treat partial ruptures of the adductor longus tendon, especially if non-operative treatment is insufficient and RTP is threatened. MRI and hip strength assessments may provide valuable information during the rehabilitation of the partial acute-on-chronic rupture of the adductor longus tendon.


Read article: Kosola et al 2016 Adductor Case Report (pdf)

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