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Adductor De-Tensioning

What is Adductor De-Tensioning?

Adductor de-tensioning is a surgical procedure employed for the treatment of individuals with chronic adductor strain who have failed to recover following conservative treatment.

Adductor strain or groin strain is an acute injury to the adductor muscles on the medial aspect of the thigh and are one of the most common causes of medial leg and groin pain, especially among athletes. During adductor strain, the proximal part of the muscle is the region that is most commonly affected, tearing near their bony attachments in the pelvis.

Adductor muscles play a vital role in most of the weight-bearing activities and sports and undergo extreme strain due to repetitive motion. Adductor strain most commonly occurs in athletes who are involved in football, rugby, soccer, hockey, basketball, and running that involves swift changes in speed and direction, kicking, twisting and turning, etc.

Adductor muscles are a group of 5 powerful muscles located in the medial compartment of the thigh that are collectively referred to as hip adductors. The adductor muscles function by assisting in:

  • Bringing the thighs together (adduction) at the hip joint
  • Flexion and medial rotation of the femur at the hip joint
  • Flexion of the knee and medial rotation of that flexed knee
  • Adduction and flexion of the femur at the hip joint

Indications for Adductor De-Tensioning

Some of the common indications for adductor de-tensioning include:

  • Osteitis pubis
  • Sportsmen's groin, also called sports hernia and Gilmore groin
  • Adductor strain, also known as groin pull or groin strain
  • Snapping hip syndrome
  • Overuse stress fractures
  • Inguinal hernia

Preparation for Adductor De-Tensioning

Preoperative preparation for adductor de-tensioning includes:

  • A thorough examination by your doctor to check for any medical issues that need to be addressed prior to surgery.
  • Medical evaluation, blood work, and imaging may be ordered for safely conducting surgery.
  • You will be asked questions with regard to any allergies to medications or anesthesia.
  • You should inform your doctor of any medications, vitamins, or supplements that you may be taking.
  • You should refrain from medications or supplements such as blood thinners, NSAIDs, or vitamin E for several days prior to the surgery.
  • You should not consume any solids or liquids at least 8 hours prior to the surgery.
  • Arrange for someone to drive you home as you will not be able to drive yourself post surgery.
  • A written consent will be obtained from you after the surgical process has been explained in detail.

Procedure for Adductor De-Tensioning

The procedure is mostly performed as a same-day surgery, although a short overnight stay may be needed. The procedure involves the following steps:

  • Local or general anesthesia is administered prior to beginning the surgery.
  • Your surgeon makes a 3 cm long incision overlying the adductor muscle group.
  • Your surgeon then carefully gains access to the adductor muscles.
  • The muscles and the tendons are evaluated for any pathology or abnormalities.
  • The affected adductor muscles are individually de-tensioned (freed up).
  • If the muscles are found to be torn or ruptured, a repair is then performed accordingly.
  • The incisions are closed with stitches and a sterile dressing applied.

Postoperative Care and Instructions

The general postoperative care and instructions involve:

  • You will be transferred to the recovery area to be monitored until you are awake from the anesthesia.
  • Your nurse will monitor your blood oxygen level and other vital signs as you recover.
  • You should get up and walk every hour or two to prevent blood clot formation.
  • You can expect pain and soreness in the groin area. Pain medications will be prescribed for comfort.
  • Instructions on surgical site care, driving, and bathing will be provided.
  • Refrain from smoking as it can negatively affect the healing process.
  • Refrain from any strenuous activities and do not lift any heavyweights. You should gradually increase your activity level with light activities.
  • You may return to normal activities in a couple of weeks, but return to sport is only expected at 6 weeks post procedure.
  • A follow-up appointment will be scheduled at 2nd and 4th week post surgery to monitor your progress.

Risks and Complications of Adductor De-Tensioning

Some of the risks and complications of adductor de-tensioning include:

  • Pain
  • Infection
  • Bleeding
  • Anaesthetic complications
  • Blood clot or venous thrombosis
  • Damage to adjacent organs
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