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Treatment of Osteitis Pubis in Athletes

Results of Corticosteroid Injections

Division of Orthopedic Surgery, University of Wisconsin, Madison, Wisconsin

James S. Keene, MD

Division of Orthopedic Surgery, University of Wisconsin, Madison, Wisconsin

Ben K. Graf, MD

Division of Orthopedic Surgery, University of Wisconsin, Madison, Wisconsin

Dennis C. Helwig, ATC

Division of Intercollegiate Athletes, University of Wisconsin, Madison, Wisconsin

This study presents the results of treatment of osteitis pubis in 12 intercollegiate athletes. Early in this series, athletes were treated with prolonged rest, oral antiin flammatory medications, and hip-stretching exercises. Of the nine athletes treated in this manner, only one resumed symptom-free activity after 16 weeks of therapy; eight remained symptomatic and subsequently received a corticosteroid injection (1 ml 1% lidocaine, 1 ml 0.25% bupivacaine, and 4 mg dexamethasone) into the pubic symphysis. Of these eight athletes, three returned to full participation within 3 weeks of injection, four required a second injection to alleviate their symp toms, and one was unable to resume athletic activities despite two injections and an inguinal herniorrhaphy. In recent years, we have recommended an injection if there is no reduction in symptoms after 7 to 10 days of treatment. Three athletes received a corticosteroid in jection when their symptoms did not resolve. All three returned to full athletic competition within 2 weeks of the injection. The results of our study suggest that a more rapid return to intercollegiate athletics can be achieved through the judicious use of corticosteroid injections.

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