Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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27. The Role of Bioactive Prosthetic Material for the Treatment of Sports Hernias David S. Edelman Editor’s Comments (ST) Athletic pubalgia remains one of the most controversial topics in the arena of groin pain. Few surgeons in the world have chosen this specialty for their main focus of practice, and among them, they each have a different approach as to how and why they perform their procedure(s) of choice. Here, the author presents his unique practice of laparoscopic approach to the treatment of athletic muscle tears, with the addition of Surgisis, a porcine tissue derived from small intestine submucosa, and fibrin. The term “BPM” is often applied when discussing Surgisis and other Cook products, whereas the broader term of “biologic” mesh can also be used when discussing human or nonhuman collagen-based grafts. Also, Table 27.1 demonstrates data as provided by each vendor, such as whether the tissue has been intentionally cross-linked. This information may not represent analyses performed independently by scientific laboratories that have shown a special interest in determining the final characteristics of implanted tissue, such as whether the sterilization and other manipulation of the tissue in fact result in unintentional overprocessing or even cross-linking. Nevertheless, the technique described is worthy of further discussion and investigation. The author has shown good preliminary results. We look forward to larger population and longer-term data. It would be useful to know if other forms of collagen matrices would also show benefit when implanted in this region and also which specific patients are best candidates to undergo this type of approach for their athletic pubalgia. © Springer International Publishing Switzerland 2016 B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain, DOI 10.1007/978-3-319-21587-7_27 365
366 D.S. Edelman Table 27.1. Bioactive prosthetic materials. Crosslinking Sterilization Mesh name Vendor Source ® AlloDerm LifeCell Human dermis No None ® AlloMax Bard/Davol Human dermis No Gamma irradiation CollaMend Bard/Davol Porcine dermis Yes Ethylene oxide FlexHD Ethicon Human dermis No None FortaGen ® Organogenesis Porcine intestine Yes Gamma irradiation ® MatriStem ACell Porcine bladder No E-beam ® Peri-Guard Synovis Bovine pericardium Yes Liquid alcohol Permacol Covidien Porcine dermis Yes Gamma irradiation ® Strattice LifeCell Porcine dermis No E-beam ® SurgiMend TEI Biosciences Fetal bovine dermis No Ethylene oxide ® Surgisis Cook Medical Porcine intestine No Ethylene oxide Tutopatch ® Tutogen Medical Bovine pericardium No Gamma irradiation ® Veritas Synovis Bovine pericardium No E-beam ® XenMatrix Bard/Davol Porcine dermis No E-beam Introduction The use of mesh in the repair of hernias is commonplace. Synthetic meshes such as polypropylene and polyester have been the standard for hernia repairs since the 1980s. Biologic graft material composed of purified porcine small intestinal submucosa was first introduced to the United States in 1998, as an alternative to synthetic biomaterials. These meshes, composed of extracellular matrix (ECM) collagen, fibronectin, associated glycosaminoglycans, and growth factors [ 1 – 4 ], have been extensively investigated in animal models [ 5 – 7 ] and used clinically in many types of surgical procedures. Referred to as bioactive prosthetic materials ( BPM ) , they are considered a scaffold for the binding of growth factors and other cellular elements for the healing response. The subsequent healing response and strength are dependent on ingrowth from the patient’s cells and blood vessels into the ECM of the BPM. Fibrin may assist this ingrowth and thus may be added extrinsically as topical fibrin sealant [ 8 ]. The balance between ECM synthesis and degradation contributes to the ultimate success of the hernia repair. Surgisis (Cook Surgical, Bloomington, IN) was the first biologic graft material to be marketed in the United States. I began using it in my practice for hernia repairs and reported my initial results in Surgical
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Brian P. Jacob · David C. Chen Bru
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The SAGES Manual of Groin Pain Bria
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Foreword Inguinal hernia repair is
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Contents Part I Primary Groin Pain
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Contents ix 22 Management of Inguin
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Contents xi 45 Value-Based Clinical
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xiv Editors and Contributors Jeffre
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xvi Editors and Contributors David
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xviii Editors and Contributors Greg
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xx Editors and Contributors David S
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1. Introduction to Primary and Seco
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10 I.A. Gawlas and W.J. Peacock Ili
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12 I.A. Gawlas and W.J. Peacock Tra
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14 I.A. Gawlas and W.J. Peacock Var
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3. Complex Regional Pain Syndrome T
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4. Chief Complaint of Groin Pain: H
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4. Chief Complaint of Groin Pain…
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42 C. Ma and A. Ramaswamy inguinal
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44 C. Ma and A. Ramaswamy Categoriz
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46 C. Ma and A. Ramaswamy with no s
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48 C. Ma and A. Ramaswamy 26. Aasva
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50 I.M. Daoud and K. Dunn Other per
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52 I.M. Daoud and K. Dunn low herni
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54 I.M. Daoud and K. Dunn In the po
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56 I.M. Daoud and K. Dunn with a he
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58 I.M. Daoud and K. Dunn 13. O’C
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60 G.J. Mancini Occult Hernia Backg
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62 G.J. Mancini Magnetic resonance
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64 G.J. Mancini rocking motion can
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66 G.J. Mancini Unique to the adduc
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68 G.J. Mancini two nerve injuries
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70 G.J. Mancini abdominis has a rep
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72 G.J. Mancini 5. Light D, Ratnasi
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74 J.C. Campbell and G.D. Paiement
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9. Groin Pain Etiology: Spine and B
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10. Groin Pain Etiology: Spermatic
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Table 10.2. European Association of
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138 M. Hibner and C. Coyne Piriform
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140 M. Hibner and C. Coyne Fig. 11.
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142 M. Hibner and C. Coyne Table 11
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144 M. Hibner and C. Coyne present
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146 M. Hibner and C. Coyne Table 11
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148 M. Hibner and C. Coyne Once the
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150 M. Hibner and C. Coyne 3. Hibne
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12. Chronic Pelvic Pain in Women M.
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12. Chronic Pelvic Pain in Women 15
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174 J.M. Miller et al. Knowing the
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176 J.M. Miller et al. Fig. 13.2. A
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182 J.M. Miller et al. Fig. 13.9. C
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184 J.M. Miller et al. Fig. 13.14.
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192 J.M. Miller et al. Cardiac Cath
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194 B.J. Dunkin Noxious peripheral
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196 B.J. Dunkin Table 14.1. Summary
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198 B.J. Dunkin Rectus abdominis Ex
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200 B.J. Dunkin COX-1 COX-2 Celecpx
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202 B.J. Dunkin Table 14.2. Common
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204 B.J. Dunkin Possible Preoperati
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206 B.J. Dunkin Postoperative Pain
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208 B.J. Dunkin Summary Understandi
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15. Chronic Groin Pain Following An
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222 E.L. Felix not seem to alter th
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224 E.L. Felix nerves from the surg
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226 E.L. Felix Fig. 16.2. Lateral f
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228 E.L. Felix It has been establis
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230 E.L. Felix 18. Pollak R, Nyhus
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17. The Orthopedic Perspective on G
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246 J.F.M. Lange Jr. examination an
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248 J.F.M. Lange Jr. and remedial s
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250 J.F.M. Lange Jr. Best available
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252 J.F.M. Lange Jr. Neuropathic pa
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254 J.F.M. Lange Jr. This algorithm
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19. Radiologic Evaluation for Posto
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19 Radiologic Evaluation for Postop
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268 A. Malhotra extended variant of
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270 A. Malhotra steroid injections,
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272 A. Malhotra located just below
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274 A. Malhotra Nociceptive Acute N
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276 A. Malhotra 20. Rozen D, Parvez
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278 R. Álvarez intentionally or in
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Fig. 21.1. Material: A ballpoint pe
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Fig. 21.5. Dermatome mapping compat
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Fig. 21.9. Dermatome mapping compat
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286 R. Álvarez Subsequently, we mu
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288 R. Álvarez G : Granuloma H : H
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290 R. Álvarez Fig. 21.14. Same pa
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292 R. Álvarez 6. Lermite E, Arnau
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294 K.A. Seymour and J.S. Yoo Table
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296 K.A. Seymour and J.S. Yoo repro
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298 K.A. Seymour and J.S. Yoo Recur
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23. Mesh Removal for Chronic Pain:
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23. Mesh Removal for Chronic Pain
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32. Chronic Groin Pain: Mesh or No
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Part IV Case Reports and Patients
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430 S. Towfigh were irregular and s
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432 S. Towfigh in addressing her sy
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434 S. Towfigh Conclusion We have y
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436 K.W. Kercher Physical Examinati
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438 K.W. Kercher Fig. 34.4. Left ad
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440 K.W. Kercher Fig. 34.5. After d
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442 K.W. Kercher the posterior wall
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444 K.W. Kercher Table 34.2. Surgic
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35. Chronic Post-inguinal Herniorrh
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35 Chronic Post-inguinal Herniorrha
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35 Chronic Post-inguinal Herniorrha
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36. Sports Hernia with Adductor Ten
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464 C.G. DuCoin and G.R. Jacobsen P
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466 C.G. DuCoin and G.R. Jacobsen O
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468 J.A. Blatnik and A.S. Prabhu a
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470 J.A. Blatnik and A.S. Prabhu Fi
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472 J.A. Blatnik and A.S. Prabhu ma
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474 S. Towfigh Physical Exam The pa
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476 S. Towfigh The patient’s loca
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478 S. Towfigh Fig. 39.2. Diagram o
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480 S. Towfigh periphery. He is 2+
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482 S. Towfigh References 1. Matthi
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484 N.A. Al-Enazi and B.P. Jacob
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486 N.A. Al-Enazi and B.P. Jacob Fi
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488 N.A. Al-Enazi and B.P. Jacob pu
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42. Patient with Chronic Pelvic Pai
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42. Patient with Chronic Pelvic Pai
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43. Thoracolumbar Syndrome James A.
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43. Thoracolumbar Syndrome 497 The
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43. Thoracolumbar Syndrome 499 Groi
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44. Patient with Referred Hip Pain
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44. Patient with Referred Hip Pain
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45. Value-Based Clinical Quality Im
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46. Patient Care Manager Perspectiv
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47. Workers’ Compensation: An Occ
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532 Index Athletic pubalgia (cont.)
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534 Index Chronic post-herniorrhaph
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536 Index Groin pain (cont.) magnet
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538 Index Ilioinguinal nerve (IIN)
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540 Index Local anesthetics (cont.)
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542 Index Peripheral nerve entrapme
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544 Index S Sacroiliac (SI) joint d
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546 Index Transperineal pudendal ne
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Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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