The painful groin is a challenging entity. The complexity of groin anatomy, the similarity of symptoms for different pathologies that may coexist may lead to a diagnostic dilemma and to delays in treatment. The purpose of the study is to assess the prevalence of symptoms consistent with adductor enthesopathy in patients require arthroscopic surgery for treatment of femoroacetabular impingement (FAI) and to evaluate the results of surgical treatment for both of these disorders.

Prospectively collected data were retrieved to identify patients with both symptomatic FAI and adductor enthesopathy at the time of presentation. Demographics, clinical examination, imaging signs of hip impingement and adductor enthesopathy were recorded. Isometric strength testing of the adductors and abductors was measured in both legs using a handheld dynamometer. Patients completed the modified Harris hip score (MHHS) pre and postoperatively and pain was evaluated on a visual analog scale.

From our database of 1135 patients were included 38 (3.34%) patients (44 hips). There were 31 males and 7 females with a mean age 36.8 years (20–63, SD 11.6). Mean follow-up was 27.7 months (SD 19.7). Pubic cleft injections were carried out in 37 (84.09%) hips and 20 (45.4%) hips underwent selective partial adductor release. All of the patients (100%) underwent hip arthroscopic surgery for FAI. Maximum improvement in strength was observed at two months postoperatively both on the operated and non-operated side compared to preoperative strength. The MHHS improved from mean 60 (21–74, SD 16.2) preoperatively to 79 (30–100, SD 17.6) postoperatively and VAS for pain from 6.9 (SD 1.7) to 2.8 (SD 2.6).

When FAI and adductor enthesopathy are present then both pathologies should be addressed simultaneously or in a staged manner to optimize the postoperative outcomes. Pubic cleft injections and selective partial adductor release are valuable therapeutic procedures in patients treated for symptomatic FAI.