Experience with "sports hernia" spanning two decades.

Objective And Background: Athletic pubalgia (AP) is a leading cause of athlete loss from competitive sports. Commonly misnamed "sports hernia," AP is a set of pelvic injuries involving the abdominal and pelvic musculature outside the ball-and-socket hip joint and on both sides of the pubic symphysis. Prospective studies show that timely intervention and appropriate repair of selected injuries results in greater than 95% success.

Methods: The senior author reviewed his experience with 8,490 patients and 5,460 operations, looking primarily at the changes in patient characteristics over the last 2 decades and at some of the advances.

Results: Female proportion, age, numbers of sports, and soft tissue structures involved have all increased as have the number of syndromes identified and number of operations. MRI has improved greatly for both the diagnosis of hip and nonhip pathology in the pelvis. Increased understanding has led also to new rehabilitation and performance protocols.

Conclusions: Better understanding and recognition of the injuries has led to more satisfactory care and returned many athletes to successful careers, which has had a major impact on modern sport.