Background:

Time to return-to-sport (RTS) after acute adductor injuries varies among athletes, yet we know little about which factors determine this variance.

Purpose:

To investigate the association between initial clinical and imaging examination findings and time to RTS in male athletes with acute adductor injuries.

Study Design:

Cohort study (Prognosis); Level of evidence, 2.

Methods:

Male adult athletes with an acute adductor injury were included within 7 days of injury. Standardized patient history and clinical and magnetic resonance imaging (MRI) examinations were conducted for all athletes. Athletes performed a supervised standardized criteria-based exercise treatment program. Three RTS milestones were defined: (1) clinically pain-free, (2) completed controlled sports training, and (3) first full team training. Univariate and multiple regression analyses were performed to determine the association between the specific candidate variables of the initial examinations and the RTS milestones.

Results:

We included 81 male adult athletes. The median duration for the 3 RTS milestones were 15 days (interquartile range, 12-28 days), 24 days (16-32 days), and 22 days (15-31 days), respectively. Clinical examination including patient history was able to explain 63%, 74%, and 68% of the variance in time to RTS. The strongest predictors for longer time to RTS were pain on palpation of the proximal adductor longus insertion or a palpable defect. The addition of MRI increased the explained variance with 7%, 0%, and 7%. The strongest MRI predictor was injury at the bone-tendon junction. Post hoc multiple regression analyses of players without the 2 most important clinical findings were able to explain 24% to 31% of the variance, with no added value of the MRI findings.

Conclusion:

The strongest predictors of a longer time to RTS after acute adductor injury were palpation pain at the proximal adductor longus insertion, a palpable defect, and/or an injury at the bone-tendon junction on MRI. For athletes without any of these findings, even extensive clinical and MRI examination does not assist considerably in providing a more precise estimate of time to RTS.

中文翻译：

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男性急性加成器损伤的初始临床检查和影像学发现与运动恢复之间的关联：一项前瞻性队列研究。

背景：

急性内收肌受伤后运动员恢复运动的时间各不相同，但我们不清楚哪些因素决定了这种差异。

目的：

调查最初的临床和影像学检查结果与急性内收肌损伤的男运动员RTS时间之间的关联。

学习规划：

队列研究（预后）；证据水平2。

方法：

受伤后7天之内包括患有急性内收肌损伤的男性成年运动员。对所有运动员进行了标准化的患者病史以及临床和磁共振成像（MRI）检查。运动员执行了监督的基于标准的标准运动治疗程序。定义了三个RTS里程碑：（1）临床无痛，（2）完成受控运动训练以及（3）第一次完整的团队训练。进行单变量和多元回归分析，以确定初始检查的特定候选变量与RTS里程碑之间的关联。

结果：

我们包括81名男性成年运动员。这三个RTS里程碑的中位持续时间分别为15天（四分位间距为12-28天），24天（16-32天）和22天（15-31天）。包括患者病史在内的临床检查能够解释63％，74％和68％的RTS时间差异。延长RTS时间的最强预测因素是触及近端内收肌长肌插入时的疼痛或可触及的缺损。MRI的增加使解释的方差分别增加了7％，0％和7％。MRI最强的预测指标是骨腱连接处的损伤。没有2个最重要的临床发现的球员的事后多元回归分析能够解释24％到31％的差异，而MRI发现没有附加值。

结论：

急性内收肌损伤后较长时间到达RTS的最强预测指标是近端内收肌长肌插入时触诊疼痛，可触及的缺损和/或MRI上的骨腱连接处受伤。对于没有任何这些发现的运动员，即使进行广泛的临床和MRI检查也无法明显帮助您更准确地估计RTS时间。