Research

Professor Ernest Schilders’ research has focused predominantly on groin injuries in sports and hip pain in young adults.

Groin injuries in sports

Professor Schilders is an internationally recognised and the country's leading expert in the diagnosis and treatment of adductor problems in athletes. In the past, adductor problems were difficult to treat and often career ending injuries. Currently, full adductor tenomies are still widely used, but they have an unpredictable outcome in relation to return to sports.

To resolve the adductor enigma, Professor Schilders did extensive work on the pelvic and adductor anatomy through cadaver dissection work. Following this research project, imaging protocols were developed in collaboration with musculoskeletal radiologists, which significantly improved the accuracy in assessing adductor injuries.

From 1999 onwards, conservative management of adductor problems has improved significantly, mainly through the efforts of Per Holmich. Professor Schilders was the first one to recognise the value of pubic cleft injections to treat chronic adductor enthesitis (at the insertion of the tendon). He published a study about public cleft injections in high level and professional athletes with chronic adductor pain and found that athletes who had no abnormalities on the MRI scan achieved excellent results. On the other hand, athletes who had a positive MRI scan only had a temporary benefit from the injection.

It became apparent that the level of the athlete was an important factor: Professor Schilders found that in recreational athletes good results could be obtained with injection therapy, even with abnormalities of the adductors on the MRI scan.

A small number of athletes did, however, not get better with conservative management or injection therapies and required surgery. Because the existing surgical techniques had an unpredictable outcome in relation to return to sports, Professor Schilders developed a new minimally invasive technique to allow a faster and consistent return to sports.

The terminology used to describe groin and hip conditions can be confusing. Professor Schilders was recently one of invited internationial experts from 16 different countries for a consensus meeting on terminology of groin and hip problems in sports.

Professor Schilders is the Chief investigator on a FIFA study on acute adductor injuries in football.

Hip pain in young adults

Professor Schilders has an interest in the young adult hip and has been pioneering complex hip arthroscopy in the UK over the past few years. Joint preservation is very important and Professor Schilders has published the largest study in the UK so far about femoro acetabular impingement. In this study he compares the outcomes of labral repairs with labral resections in patients with femoroacetabular impingement. The study demonstrates that patients who had the labrum repaired, did significantly better after a minimum of 2 year follow up than those who had the labrum resected.

Professor Schilders has also published the largest study in the UK about the results of arthroscopic treatment of femoroacetabular impingement in athletes. Surgical treatment of femoroacetabular impingement allows professional and high level athletes to return to sports and compete at pre-injury level.

Instability of the hip is still unknown and underdiagnosed: Professor Schilders was the first one in the UK to present results of arthroscopic stabilization of the hip at international conferences.

Hip conditions can significantly affect young athletes and Professor Schilders also does research in the prevention, etiology and early recognition of hip problems.

 

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