Adductor Tear Surgery: A Comprehensive Guide to Recovery and Rehabilitation

Introduction

Adductor tears are a common and often debilitating injury among athletes, particularly in sports that involve quick changes of direction or powerful leg movements. While many adductor injuries can be managed conservatively, severe tears may require surgical intervention. This comprehensive guide will explore adductor tear surgery, its indications, techniques, and the crucial rehabilitation process that follows.

Understanding Adductor Tears

The adductor muscle group, located on the inner thigh, plays a vital role in hip adduction and stabilization. Tears can range from minor strains to complete ruptures, with the adductor longus being the most commonly affected muscle. According to a systematic review by Farrell et al. (2023), soccer players are at the highest risk, accounting for 62% of adductor injuries, followed by basketball players at 14%.

Indications for Surgery

While many adductor tears can be treated conservatively, surgery may be necessary in certain cases. Kiel and Kaiser (2023) suggest that surgical management may be indicated for:

• Full-thickness tears with persistent weakness
• Avulsion injuries not responding to conservative treatment
• Chronic cases with failed non-operative management

Surgical Techniques

Adductor tear surgery has evolved to include both open and minimally invasive approaches. Lempainen et al. (2021) describe a surgical technique involving repair of the proximal adductor longus tear with concomitant distal fascial release. This approach resulted in excellent or good outcomes in 90% of cases, with athletes returning to sports at an average of 18.5 weeks post-surgery.

Post-Operative Care and Rehabilitation

Proper rehabilitation is crucial for successful recovery after adductor tear surgery. A structured program typically includes:

1. Initial period of rest and protection
2. Gradual range of motion exercises
3. Progressive strengthening of the adductor and surrounding muscles
4. Sport-specific training and return-to-play protocols

Davies et al. (2013) reported significant improvements in Harris hip scores from 53 points preoperatively to 88 points at five years post-surgery, highlighting the long-term benefits of proper surgical repair and rehabilitation.

Return to Sport

The timeline for return to sport can vary depending on the severity of the injury and the demands of the athlete's sport. Silva et al. found that NFL players treated surgically returned to play at an average of 12 weeks, while those treated non-operatively returned at 6.1 weeks. However, it's important to note that each case is unique and should be managed individually.

Conclusion

Adductor tear surgery can be an effective treatment for severe tears that don't respond to conservative management. With advances in surgical techniques and rehabilitation protocols, many athletes can expect to return to their pre-injury level of performance. However, the decision to undergo surgery should be made carefully, considering factors such as the severity of the tear, the athlete's goals, and the potential for non-operative recovery. As with any surgical procedure, proper post-operative care and adherence to a structured rehabilitation program are essential for optimal outcomes.