Surgery effective for pelvic sports injury

NEW YORK (Reuters Health) - A pelvic injury that plagues many athletes can be successfully treated with surgery; and the operation lets them return to normal activity relatively quickly, Australian researchers report.

The injury, osteitis pubis, occurs when the joint between the pubic bones at the front of the pelvis -- the pubic symphysis -- becomes inflamed, leading to pain in the groin area and loss of flexibility. An overuse injury, it commonly affects soccer players, rugby players, long-distance runners, football players, Australian rules footballers, and ice hockey players.

The preferred approach to treatment has been physical therapy and rest, Drs. Ross Radic and Peter Annear of the Perth Orthopaedic and Sports Medical Centre in West Perth note. However, recovery can take several months, which may be unacceptable to professional athletes who want to return to play more quickly, they note.

Radic and Annear report on 23 athletes with osteitis pubis treated with a procedure called pubic symphysis curettage, in which cartilage is removed from the joint. All of the patients had failed earlier attempts at treatment, including steroid injections.

After the surgery, patients reported significantly less pain. Twenty-one were able to run without pain about 3 months after the surgery, on average, and 17 returned to training after an average of 4.44 months postoperatively. Sixteen of the athletes returned to full activity after an average 5.63 months.

Seventy-eight percent said their symptoms were "better or much better" after the surgery and 61 percent returned to full activities with no pain.

"Our results suggest that this relatively simple procedure can be of significant benefit to those athletes wishing to return to their previous levels of physical activity," Radic and Annear conclude. However, larger studies are needed to compare surgical outcomes with outcomes after other osteitis pubis treatment methods.

SOURCE: The American Journal of Sports Medicine, January 2008.