The success of surgery for groin disruption (Gilmore’s Groin) depends on accurate diagnosis, meticulous repair of each element of the disruption and intensive rehabilitation according to a standard rehabilitation programme. Surgery is indicated in sportsmen, who are unable to play, or fail to respond to rehabilitation.
The surgical treatment consists of restoring normal anatomy with a six-layered structural repair of the inguinal region. Adductor tenotomy is indicated in patients with persistent and troublesome adductor tears, which do not respond to conservative treatment.
Recently, following discussion with surgeons around the world, the classical Gilmore technique has been modified with the aim of reducing the recovery time, whilst maintaining the strengths of the full anatomical repair.
Many patients show signs of pubic bone stress injury (previously known as osteitis pubis) and in these cases the inguinal ligament can divided as it inserts into the pubic tubercle to reduce the tension (an inguinal ligament tenolysis). In addition the permanent suture used for the darn has been changed form a large nylon stitch to a smaller, less reactive prolene stitch. Whilst still giving the immediate strength that is required to allow rapid rehabilitation, this stitch should produce less tissue reaction and so less discomfort.
The formal repair is now known as the Marsh Modification of the Gilmore Technique.