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REVIEW  SPORT INJURIES AND REHABILITATION 

The Journal of Sports Medicine and Physical Fitness 2022 September;62(9):1219-27

DOI: 10.23736/S0022-4707.21.12669-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Prepubic aponeurotic complex injuries: a structured narrative review

Andrea BISCIOTTI 1, Gian N. BISCIOTTI 2, 3 , Cristiano EIRALE 3, Alessandro BISCIOTTI 2, Alessio AUCI 4, Stefano BONA 1, Raul ZINI 5, 6

1 IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; 2 Kinemove Rehabilitation Centers, Pontremoli, Massa-Carrara, Italy; 3 Paris Saint Germain Football Club, Paris, France; 4 Azienda USL Toscana Nord-Ovest, Massa, Massa-Carrara, Italy; 5 Maria Cecilia Hospital, Cotignola, Ravenna, Italy; 6 University of Ferrara, Ferrara, Italy



The prepubic aponeurotic complex anatomy (PPAC) consists in a fibrous capsule, which anteriorly lines the pubic symphysis, formed by the interconnection of different anatomical structures. Research of the studies (original articles, case series and review articles) was conducted without publication data limitation or language restriction on the following databases: PubMed/MEDLINE, Scopus, ISI, EXCERPTA. To date, evidence from the literature suggests that: 1) the PPAC is formed by interconnection between the tendons of the adductor longus, adductor brevis, gracilis and pectineus muscles, the aponeurosis of rectus abdominis, pyramidalis and external oblique muscles, the articular disc, the anterior pubic periostium and by the superior, inferior and anterior pubic ligament; 2) the PPAC clinical presentation may mimic a adductor longus tendon injury, the MRI examination can help to differentiate the two different clinical frameworks; 3) the PPAC injuries show a typical MRI presentation which must be differentiated from other similar but clinically different imaging frameworks; 4) the PACC injury can be treated conservatively, with medical therapies or surgically. This narrative structured review provides an insight into the PPAC the anatomy, the clinical presentation, the imaging and the treatment of the PPAC injuries.


KEY WORDS: Pubic symphysis; Imaging; Conservative treatment; Surgical procedures, operative

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