Adductor Longus Tenotomy & the BKFO Test

The Effect of an Adductor Longus Tenotomy on the Bent Knee Fall Out Test

The bent knee fall out test (BKFO) is a common test for hip adductor flexibility. It is unknown whether the BKFO actually tests the the adductors or potentially hip range of motion instead.

In this study, the BKFO test is performed in the operating theater before and after an adductor longus tenotomy.

Study Overview

• Status: Completed
• Conditions: Adductor Tendinitis
• Intervention / Treatment: Other: No intervention assigned as part of this study.

Detailed Description

Adductor-related groin pain is the most common type of groin pain in athletes, and pain at the proximal adductor longus insertion is a key finding in the diagnosis of longstanding groin pain. "Tightness" or "shortening" of the adductor longus is considered both a cause and effect of pain, that can lead to increased tension at the proximal insertion, thus playing a role in the persistence of longstanding adductor-related pain. For patients who do not respond sufficiently to non-surgical procedures, an adductor longus tenotomy is a surgical option that is considered to reduce tension at the proximal adductor longus insertion assisting in reduction of pain and return to sport.

The bent knee fall out test (BKFO) is one of the most commonly used tests to test adductor flexibility. This test involves a combined hip movement with hip flexion, abduction, and external rotation, and a high result is generally considered to be related to adductor muscle "tightness", specifically that of the adductor longus. It is uncertain whether the BKFO test is actually measuring adductor muscle flexibility or hip joint range of motion, as the test results may also be affected by a femoral head cam morphology. A slightly different test, called the Patrick FABER's test, involves a similar movement and is mainly used as a hip joint pain provocation test.

By cutting the adductor longus tendon, thereby removing the effect of potential adductor longus "tightness", it will be possible to show if and how much the flexibility of this muscle affects the BKFO test results. This will assist in future considerations of what this test is actually testing.

The aim of this study is to investigate the immediate effect of an adductor longus tenotomy on the results of the bent knee fall out test.

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• France
  • Merignac, France, 33700
    • Clinique du sport Bordeaux - Mérignac

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

• Sampling Method: Non-Probability Sample

Study Population

Athletes with groin pain are consecutively recruited from two clinics of a visceral surgeon specialized in groin pain in athletes. The clinics are located in Bordeaux and Paris, France, and patient population includes athletes from all over France.

Description

Inclusion Criteria:

• adults (>18 years old)
• athletes (recreational or elite)
• clinical diagnosis of adductor-related groin pain
• patients undergoing unilateral or bilateral adductor longus tenotomy by one general surgeon.

Exclusion Criteria:

• No specific exclusion criteria were present other than refusal to participate in the study.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in the Bent Knee Fall Out test	The patient lies supine on the surgical table with app. 90° knee flexion, 45° hip flexion, and the feet together and the hips in external rotation (also known as the frog-leg position. Standardization of position is achieved by flexing one leg first, so the medial malleolus is placed next to the medial knee joint line of the contra-lateral leg. The knee is then moved laterally, externally rotating the hip with the plantar surface placed towards the contra-lateral leg. The contra-lateral leg is then flexed, and the plantar surfaces of the feet are aligned. The distance between the most distal point on the head of the fibula and the surface of the surgical table is measured using a rigid tape measure and distance is recorded in cm to the nearest 0.5 cm	Baseline pre-surgery and immediately after the surgery.

Collaborators and Investigators

• Sponsor: Aspetar
• Collaborators: Clinique du sport

Study record dates

Study Major Dates

• Study Start (Actual): November 22, 2019
• Primary Completion (Actual): May 22, 2020
• Study Completion (Actual): January 18, 2021

Study Registration Dates

• First Submitted: June 22, 2020
• First Submitted That Met QC Criteria: June 28, 2020
• First Posted (Actual): July 1, 2020

Study Record Updates

• Last Update Posted (Actual): August 4, 2021
• Last Update Submitted That Met QC Criteria: August 3, 2021
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Musculoskeletal Diseases; Muscular Diseases; Tendon Injuries; Tendinopathy
• Other Study ID Numbers: ALTBKFO

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided
• IPD Plan Description: There are currently no IPD plans. IPD data be obtained upon reasonable request

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No