Radiofrequency denervation of the inguinal ligament for the treatment of 'Sportsman's Hernia': a pilot study

BACKGROUND: Chronic groin pain is a common and debilitating condition in highly active athletes. Symptoms are often ascribed to the so-called Sportsman s Hernia, and these patients frequently undergo prolonged and often painful remedial physiotherapy, or, if the condition is refractory, surgery to repair the posterior inguinal wall. HYPOTHESIS: We hypothesised that radiofrequency denervation (RFD) of both the ilioinguinal nerve and inguinal ligament could be used to desensitise the groin region and enable the athlete to become pain-free. STUDY DESIGN: A prospective randomised controlled trial of three groups of patients with chronic groin pain. METHODS: Thirty-six patients with chronic groin pain of greater than 6 months duration, with no identifiable structural cause and which was refractory to conservative treatment, were randomised into two groups. Group 1 was treated with RFD (n=18), while group 2 was treated with local anaesthetic (Bupivicaine) and steroid (Trimacinolone) injection (n=18). A further 10 patients with previous failed surgery for the same condition were treated with RFD without randomisation. All patients then underwent a standardised physiotherapy regimen. The Visual Analogue Scale at rest (VASr) and with activity (VASa) was used to assess pain, and London Adductor and Abdominal Groin Score was used to assess function, at baseline and at 1 week, 3 months and 6 months post-treatment. RESULTS: RFD treatment resulted in a significant improvement above baseline in all measures and at each time intervals up to 6 months, in both the randomised Group 1 and in the postsurgery group (p values ranging from