Disclosures: Kayle E. Noble-Taylor, DO: No financial relationships or conflicts of interest

Case Description: The patient presented with a 3-year history of left adductor pain that began while marathon training. Prior management included physical therapy, intra-articular and adductor magnus corticosteroid injections, and left hip arthroscopy with labral repair and adductor longus fractional lengthening 11 months prior to presentation. Surgery and post-operative rehabilitation resolved the patient’s intraarticular hip pain, but he continued to experience adductor pain aggravated by running and golfing. His maximum pain was 7/10. His Hip Outcome Score (HOS) was 77.8%. He denied any systemic or neurologic symptoms. Exam was notable for left adductor origin pain with palpation, hip adduction and oblique sit-up. He was diagnosed with chronic left adductor tendinopathy and elected to undergo ultrasound-guided cutting wire release of the proximal adductor longus tendon. Using sterile technique, local anesthetic, ultrasound-guidance, and a 22-guage Tuohy needle, a cutting wire was threaded circumferentially around the proximal adductor tendon and used to transect the tendon without complication. Post-procedure, compression was applied and the patient was instructed to gradually increase activity after a 48 hour rest period.

Setting: Outpatient sports medicine clinic.

Patient: A 47-year-old male with chronic left adductor tendinopathy. Assessment/

Results: The patient walked without assistance immediately post-procedure. Post-procedure pain was controlled with 5 mg hydrocodone that night, and 600 mg ibuprofen twice daily for 6 days. Post-procedure HOS improved from 76.4% at 1-week to 100% at 1, 3, and 6 month follow-up. He reported full return to activity at 3 weeks post-procedure with no complications or return of symptoms.

Discussion: To our knowledge, this is the first reported case of an ultrasound-guided cutting wire release of the proximal adductor longus tendon. There were no complications and the patient rapidly returned to normal activities.

Conclusion: Ultrasound-guided proximal adductor tendon release may be a safe and effective treatment for chronic adductor tendinopathy.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/ultrasound-guided-proximal-adductor-longus-cutting-wire-release-for-management-of-chronic-adductor-tendinopathy-a-case-report/