Professorial Inaugural Lecture by Professor Ernest Schilders
Examining the complexity of athlete's groin injuries.
Professor Ernest Schilders is an internationally recognised orthopaedic surgeon who specialises in hip and groin pain in young adults. He is the country's leading expert in adductor problems in sports.
Groin injuries are known to be one of the most difficult areas to treat in sports medicine. Understanding of the athlete’s groin has been hampered by perplexing terminology and the use of incorrect anatomical concepts. Professor Schilders’ innovative research has contributed significantly towards clearer understanding, diagnosis and treatment of these conditions. Groin injuries in sports are a complex conceptual and scientific knot, with an ever expanding number of strings.
During his lecture Professor Schilders will elaborate on how the strings started to unravel for him.
Understanding the sometimes intricate clinical patterns of groin problems is only possible with a clear knowledge of the correct anatomy of the symphyseal area; over the last 20 years Professor Schilders has conducted five cadaver dissection studies of the aforementioned area. The main discovery was the existence of the pyramidalis-anterior pubic ligament-adductor longus complex. This complex connects the adductor area to the rectus abdominis and inguinal area. The only abdominal muscle anterior to the pubis is the pyramidalis muscle. Crucially, the adductor longus does not have a direct connection with the rectus abdominis. Surprisingly, these findings were found to already be present in numerous anatomy textbooks, from a variety of different countries, with a chronological spread from the 18th to the early 20th century. Even more astoundingly, the anatomy as described in these classic textbooks did not filter through to the current literature, which still adopts the view that the adductor longus is directly connected with the rectus abdominis.
The dissection work has allowed to establish a clear understanding of the anatomy. An MRI protocol was developed to examine the detailed anatomy and diagnose adductor complex injuries. Thus it became possible to perform anatomical repairs of complex injuries allowing a quick return to sports. Professor Schilders has put in place the groundwork for a new consensus of understanding regarding Groin injuries in Sports medicine.