Surgical Technique: Endoscopic Proximal Adductor Lengthening

Proximal adductor injuries are relatively common groin injuries in athletes. Various tenotomy techniques have been described including open, partial, endoscopic, and percutaneous approaches. Current techniques have led to the majority of athletes returning to sport; however, many develop adductor weakness. Moreover, many of these procedures lack full visualization of the tendon and do not allow for return to athletes’ preinjury level of play. In this chapter, we describe an endoscopic z-lengthening of the proximal adductor tendon with the potential to minimize complications associated with open procedures such as incisional pain and neurovascular injury while affording a more complete tenotomy than current techniques (Bharam et al., Arthrosc Tech 7:e675-8, 2018).This is a safe and reproducible technique that allows for release of tension as a result of pathologic adductor tendon pathologies.