Adductor tendinopathy as a source of ongoing chronic postoperative inguinal pain—evaluating outcomes of adductor tenotomy

PURPOSE: To evaluate the outcome of an adductor muscle tenotomy in patients with chronic postoperative inguinal pain (CPIP) with a therapy-resistant adductor tendinopathy. METHODS: In this retrospective cohort study, CPIP patients who underwent an adductor tenotomy between January 2019 and December 2024 at MMC were identified using a CTcue search and an operative code. They were categorised according to the extent of surgical procedure (isolated group: adductor tenotomy only; combined group: mesh removal and/or tailored neurectomy combined with adductor tenotomy). Outcome was successful (excellent or good) or not (moderate or poor). RESULTS: A total of 32 tenotomies were identified in 29 CPIP patients (25 males, mean age 59 years). All had previously undergone conservative therapies without achieving significant pain relief. The success rate in the isolated group was 57.1% (8 of 14 procedures). Success in the combined group was attained by 61.1% (11 of 18 procedures). No major complications were reported. CONCLUSIONS: Adductor tendinopathy can contribute to symptoms in some patients with CPIP. An adductor muscle tenotomy may be effective in approximately 60% of CPIP patients with a therapy-resistant adductor tendinopathy, either as an isolated procedure or as an adjunct during mesh removal and/or tailored neurectomy. These preliminary findings call for the need of further studies with standardised diagnostic criteria and validated outcome measures.