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Regenerative Injection of Elite Athletes with Career-Altering Chronic Groin Pain Who Fail Conservative Treatment: A Consecutive Case Series

Topol GA, Reeves KD: Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series. Am J Phys Med Rehabil 2008;87;890–902. Objective:To obtain multisport and long-term outcome data from the use of regenerative injection therapy on career-threatened athletes. Design:Consecutive enrollment of elite performance-limited athletes with chronic groin/abdominal pain who failed a conservative treatment trial. The treatment consisted of monthly injections of 12.5% dextrose in 0.5% lidocaine in abdominal and adductor attachments on the pubis. Injection of the nociceptive source was confirmed by repetition of resistive testing 5 mins after injection. Results:Seventy-five athletes were enrolled. Seventy-two athletes (39 rugby, 29 soccer, and 4 other) completed the minimum two-treatment protocol. Their data revealed a mean groin pain history of 11 (3–60) mos. Average number of treatments received was 3 (1–6). Individual paired t tests for Visual Analog Scale (VAS) of pain with sport (VAS Pain) and Nirschl pain phase scale measured at 0 and an average of 26 (6–73) mos indicated VAS Pain improvement of 82% (P < 10−10) and Nirschl pain phase scale improvement of 78% (P < 10−10). Six athletes did not improve following regenerative injection therapy treatment, and the remaining 66 returned to unrestricted sport. Return to unrestricted sport occurred in an average of 3 (1–5) mos. Conclusions:Athletes returned to full elite-level performance in a timely and sustainable manner after regenerative injection therapy using dextrose.