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Dr Shaan Patel, Orthopedic Hand, Wrist, Elbow and Shoulder Surgeon, Mount Juliet,Lebanon, TN // Advanced Orthopedic Treatment Plans for Hand, Wrist, Elbow, and Shoulder // Tendon Repair

What is Adductor Tendon Repair?

Adductor tendon repair is a surgical procedure employed for the treatment of individuals with severe and/or chronic adductor strain or groin strain who have failed to recover with conservative treatment.

The adductor muscles are a bunch of muscles in the groin area that is comprised of 6 main muscles: adductor longus, adductor brevis, adductor magnus, obturator externus, gracilis, and pectineus. They begin at the pelvic bone and attach at the femur (thigh) and tibia (leg) bones. Their chief function is to bring the thigh and hip towards the body (adduction). An adductor strain or groin strain is a pull, stretch, or tear in any of these muscles or their tendons and are one of the most common causes of medial leg and groin pain, especially among athletes. Nearly 64% of all groin injuries involve the adductor tendons.

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. 

Indications for Adductor Tendon Repair

Some of the indications for adductor tendon repair 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 Tendon Repair

Preoperative preparation for adductor tendon repair includes:

  • A thorough examination by your doctor to check for any medical issues that need to be addressed prior to surgery.
  • Medical evaluation and imaging may be ordered to detect any abnormality around the site of injury.
  • Make sure to inform your doctor if you have 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 surgery.
  • You should not consume any solids or liquids at least 8 hours prior to surgery.
  • You should refrain from smoking as tobacco affects blood circulation and increases the risk of complications.
  • 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 Tendon Repair

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 to 4 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 pathology or abnormalities.
  • Any mid-substance tears (tears not occurring at the attachment point) are located and repaired accordingly.
  • The involved muscles are individually de-tensioned to promote healing.
  • A tendon rupture from its origin is identified.
  • The pubis is drilled and prepared to re-approximate the tendon to its origin with suture anchors to restore their anatomical relationship.
  • The tissues are closed in layers, and a sterile dressing is applied.

Postoperative Care and Instructions of Adductor Tendon Repair

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 will be encouraged to get up and walk as frequently as possible to prevent blood clot formation.
  • You can expect pain and soreness in the groin area. Pain medications will be prescribed for comfort.
  • Refrain from any strenuous activities and do not lift any heavyweights. You should gradually increase your activity level with light activities.
  • Physical therapy and exercise regimen will be gradually started to enhance range of motion and help strengthen core muscles.
  • Instructions on surgical site care, driving, and bathing will be provided.
  • Refrain from smoking as it can negatively affect the healing process.
  • You may return to normal activities in a couple of weeks but return to sport will depend on the extent of muscle injury and may require 6 to 12 weeks or longer.
  • Strictly adhere to scheduled follow-up appointments to monitor your progress.

Risks and Complications of Adductor Tendon Repair

Some of the risks and complications of adductor tendon repair include:

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