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Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes

PURPOSE: The purpose of the study is to review the MRI findings in a cohort of athletes who sustained acute traumatic avulsions of the adductor longus fibrocartilaginous entheses, and to investigate related injuries namely the pyramidalis–anterior pubic ligament–adductor longus complex (PLAC). Assoc...

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Autores principales: Schilders, Ernest, Mitchell, Adam W. M., Johnson, Rowena, Dimitrakopoulou, Alexandra, Kartsonaki, Christiana, Lee, Justin Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Hip
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298372/
https://www.ncbi.nlm.nih.gov/pubmed/32767053
http://dx.doi.org/10.1007/s00167-020-06180-5
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author Schilders, Ernest
Mitchell, Adam W. M.
Johnson, Rowena
Dimitrakopoulou, Alexandra
Kartsonaki, Christiana
Lee, Justin Charles
author_facet Schilders, Ernest
Mitchell, Adam W. M.
Johnson, Rowena
Dimitrakopoulou, Alexandra
Kartsonaki, Christiana
Lee, Justin Charles
author_sort Schilders, Ernest
collection PubMed
description PURPOSE: The purpose of the study is to review the MRI findings in a cohort of athletes who sustained acute traumatic avulsions of the adductor longus fibrocartilaginous entheses, and to investigate related injuries namely the pyramidalis–anterior pubic ligament–adductor longus complex (PLAC). Associated muscle and soft tissue injuries were also assessed. METHODS: The MRIs were reviewed for a partial or complete avulsion of the adductor longus fibrocartilage, as well as continuity or separation of the adductor longus from the pyramidalis. The presence of a concurrent partial pectineus tear was noted. Demographic data were analysed. Linear and logistic regression was used to examine associations between injuries. RESULTS: The mean age was 32.5 (SD 10.9). The pyramidalis was absent in 3 of 145 patients. 85 of 145 athletes were professional and 52 competed in the football Premier League. 132 had complete avulsions and 13 partial. The adductor longus was in continuity with pyramidalis in 55 athletes, partially separated in seven and completely in 81 athletes. 48 athletes with a PLAC injury had a partial pectineus avulsion. Six types of PLAC injuries patterns were identified. Associated rectus abdominis injuries were rare and only occurred in five patients (3.5%). CONCLUSION: The proximal adductor longus forms part of the PLAC and is rarely an isolated injury. The term PLAC injury is more appropriate term. MRI imaging should assess all the anatomical components of the PLAC post-injury, allowing recognition of the different patterns of injury. LEVEL OF EVIDENCE: Level III.
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spelling pubmed-82983722021-08-12 Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes Schilders, Ernest Mitchell, Adam W. M. Johnson, Rowena Dimitrakopoulou, Alexandra Kartsonaki, Christiana Lee, Justin Charles Knee Surg Sports Traumatol Arthrosc Hip PURPOSE: The purpose of the study is to review the MRI findings in a cohort of athletes who sustained acute traumatic avulsions of the adductor longus fibrocartilaginous entheses, and to investigate related injuries namely the pyramidalis–anterior pubic ligament–adductor longus complex (PLAC). Associated muscle and soft tissue injuries were also assessed. METHODS: The MRIs were reviewed for a partial or complete avulsion of the adductor longus fibrocartilage, as well as continuity or separation of the adductor longus from the pyramidalis. The presence of a concurrent partial pectineus tear was noted. Demographic data were analysed. Linear and logistic regression was used to examine associations between injuries. RESULTS: The mean age was 32.5 (SD 10.9). The pyramidalis was absent in 3 of 145 patients. 85 of 145 athletes were professional and 52 competed in the football Premier League. 132 had complete avulsions and 13 partial. The adductor longus was in continuity with pyramidalis in 55 athletes, partially separated in seven and completely in 81 athletes. 48 athletes with a PLAC injury had a partial pectineus avulsion. Six types of PLAC injuries patterns were identified. Associated rectus abdominis injuries were rare and only occurred in five patients (3.5%). CONCLUSION: The proximal adductor longus forms part of the PLAC and is rarely an isolated injury. The term PLAC injury is more appropriate term. MRI imaging should assess all the anatomical components of the PLAC post-injury, allowing recognition of the different patterns of injury. LEVEL OF EVIDENCE: Level III. Springer Berlin Heidelberg 2020-08-06 2021 /pmc/articles/PMC8298372/ /pubmed/32767053 http://dx.doi.org/10.1007/s00167-020-06180-5 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Hip
Schilders, Ernest
Mitchell, Adam W. M.
Johnson, Rowena
Dimitrakopoulou, Alexandra
Kartsonaki, Christiana
Lee, Justin Charles
Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes
title Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes
title_full Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes
title_fullStr Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes
title_full_unstemmed Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes
title_short Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes
title_sort proximal adductor avulsions are rarely isolated but usually involve injury to the plac and pectineus: descriptive mri findings in 145 athletes
topic Hip
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298372/
https://www.ncbi.nlm.nih.gov/pubmed/32767053
http://dx.doi.org/10.1007/s00167-020-06180-5
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