Surgery versus conservative treatment in soccer players with chronic groin pain: A prospective randomised study in soccer players

J. Ekstrand, and S Ringborg: Surgery versus conservative treatment in soccer players with chronic groin pain: A prospective randomised study in soccer players. Eur.J. Sports Traumatol. rel, res. 23:141-145,2001. We compared surgery with conservative treatment in 66 soccer players with chronic groin pain and verified pathology in the form of incipient hernia at hemiography and/or positive nerve block test of the ilioinguinal or iliohypogastric nerves. The patients were randomised into 4 groups: surgery, individual training, physiotherapy and controls. All were evaluated preoperatively and postoperatively at 3 and 6 months using a Visual Analogue Scale (VAS) regarding pain on coughing, jogging, sprinting, kicking and sit-ups. The patients in the non-surgery groups were offered crossover to surgery after 3-6 months if their symptoms persisted. The control-group in our study did not show any change in their symptoms during the six-month follow-up period. This would imp v that expectation alone does not help these patients since the chronic groin pain did not disappear spontaneously. Conventional conservative treatment had little or no effect on the symptoms. Neither individual training nor treatment with NSAID and physiotherapy had effect on the pain apart from a minor decrease in pain on jogging, sprinting and kicking at 3 months. At 6 months there was no difference in any variable between the controls and the groups who received conservative treatment. The patients who underwent surgery had significantly less pain in all variables throughout the follow-up period. The superiority of surgery over conservative or no treatment was further emphasised in the crossover test. (C)2001, Editrice Kurtis.