University of Oulu

Lempainen, L., Hetsroni, I., Kosola, J. A., Sinikumpu, J. J., Mazzoni, S., & Orava, S. (2021). Proximal Adductor Longus Tendon Repair With a Concomitant Distal Fascial Release for Complete Hip Adductor Tendon Tears: Surgical Technique and Outcomes in 40 Male Athletes. Orthopaedic Journal of Sports Medicine.

Proximal adductor longus tendon repair with a concomitant distal fascial release for complete hip adductor tendon tears : surgical technique and outcomes in 40 male athletes

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Author: Lempainen, Lasse1; Hetsroni, Iftach2,3; Kosola, Jussi A.1,4;
Organizations: 1Sports Trauma Research Unit, Hospital Mehiläinen NEO, Turku, Finland
2Sports Medicine Injuries Service, Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, Israel
3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
4Department of Surgery, Kanta-Häme Central Hospital, Hämeenlinna, Finland
5PEDEGO Research group, OULU University; Oulu University Hospital; Mehiläinen Oulu, Finland
6Football club AC Milan, Milan, Italy
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: SAGE Publications, 2021
Publish Date: 2021-11-23


Background: The optimal treatment for complete avulsions of the proximal adductor longus (AL) is still debatable, and different operative and nonoperative treatment options have been suggested.

Purpose: To report surgical techniques and functional outcomes of a series of athletes who were treated operatively for proximal AL tears.

Study Design: Case series; Level of evidence, 4.

Methods: A retrospective evaluation of patients who underwent surgical repair of complete proximal AL tear with concomitant distal fascial release with or without lesions of the neighboring soft tissue structures was performed. This included preinjury Tegner score, age, number of tendons involved, time interval from injury to surgery, and postoperative complications. Self-reported outcomes were defined based on the ability to regain sports activities (excellent, good, moderate, fair, or poor). Between-group comparisons were performed to identify factors associated with improved outcomes. The Mann-Whitney nonparametric test was used for comparing continuous variables, and the Fisher exact test was used for comparing nominal variables.

Results: A total of 40 male athletes were included in the evaluation, with an average follow-up of 11 months (range, 6 months-8 years). Self-reported outcome was excellent in 23 (57.5%), good in 13 (32.5%), and moderate in 4 (10%) patients. Comparisons between patients with excellent versus good/moderate outcomes revealed nonsignificant differences regarding age at injury and preinjury Tegner score. Athletes with excellent outcomes received surgery sooner after the injury compared with athletes with good/moderate outcomes (2.4 ± 1.8 vs 11.4 ± 11.0 weeks, respectively; P < 0.01).

Conclusion: Surgical repair for complete proximal AL tears with a concomitant distal fascial release resulted in outcomes rated as good or excellent in 90% of the cases. This treatment should be considered particularly in high-level athletes with a clear tendon retraction and within the first month after the injury. Further research is nevertheless needed to compare these outcomes with other treatment alternatives to better define criteria advocating surgery.

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Series: Orthopaedic journal of sports medicine
ISSN: 2325-9671
ISSN-E: 2325-9671
ISSN-L: 2325-9671
Volume: 9
Issue: 10
Pages: 1 - 5
DOI: 10.1177/23259671211042024
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: © The Author(s) 2021. This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (, which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at