Anatomy of the Adductor Magnus Origin: Implications for Proximal Hamstring Injuries

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2016 Jan 23

PMID 26798764

Citations 8

Authors

Mitchel R Obey

Stephen M Broski

Robert J Spinner

Mark S Collins

Aaron J Krych

Affiliations

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Abstract

Background: The adductor magnus (AM) has historically been a potential source of confusion in patients with suspected proximal hamstring avulsion injuries.

Purpose: To investigate the anatomic characteristics of the AM, including its osseous origin, anatomic dimensions, and relationship to the proximal hamstring tendons.

Study Design: Descriptive laboratory study.

Methods: Dissection of the AM origin was performed in 11 (8 cadavers) fresh-frozen hip-to-foot cadaveric hemipelvis specimens. The gross anatomy and architecture of the proximal hamstring and AM tendons were studied. After dissecting the hamstring tendons away from their origin, the dimension, shape, and orientation of the tendon footprints on the ischial tuberosity were determined.

Results: The AM was identified in all cadaveric specimens. The mean tendon thickness (anterior to posterior [AP]) was 5.7 ± 2.9 mm. The mean tendon width (medial to lateral [ML]) was 7.1 ± 2.2 mm. The mean tendon length was 13.1 ± 8.7 cm. The mean footprint height (AP dimension) was 12.1 ± 2.9 mm, and mean footprint width (ML dimension) was 17.3 ± 7.1 mm. The mean distance between the AM footprint and the most medial aspect of the conjoint tendon footprint was 8.5 ± 4.2 mm. Tendon measurements demonstrated a considerable degree of both intra- and interspecimen variability.

Conclusion: The AM tendon is consistently present just medial to the conjoint tendon at the ischial tuberosity, representing the lateral-most portion of the AM muscle. This study found wide variation in the dimensional characteristics of the AM tendon between specimens. Its shape and location can mimic the appearance of an intact hamstring (conjoint or semimembranosus) tendon intraoperatively or on diagnostic imaging, potentially misleading surgeons and radiologists. Therefore, detailed knowledge of the AM tendon anatomy, footprint anatomy, and its relationship to the hamstring muscle complex is paramount when planning surgical approach and technique.

Clinical Relevance: The reported data may aid surgeons in more accurate recognition, diagnosis, and repair of proximal hamstring avulsion injuries.

Citing Articles

Anatomical Relationships of the Proximal Attachment of the Hamstring Muscles with Neighboring Structures: From Ultrasound, Anatomical and Histological Findings to Clinical Implications.

Miguel-Perez M, Iglesias-Chamorro P, Ortiz-Miguel S, Ortiz-Sagrista J, Moller I, Blasi J Diagnostics (Basel). 2024; 14(16).

PMID: 39202213 PMC: 11353185. DOI: 10.3390/diagnostics14161725.

Isolated Adductor Magnus Injuries in Athletes: A Case Series.

Mecho S, Balius R, Bossy M, Valle X, Pedret C, Ruiz-Cotorro A Orthop J Sports Med. 2023; 11(1):23259671221138806.

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Modified surgical anchor refixation in older patients with acute proximal hamstring rupture: clinical outcome, patient satisfaction and muscle strength.

Chocholac T, Buhl L, Nuesch C, Bleichner N, Mundermann A, Stoffel K Arch Orthop Trauma Surg. 2023; 143(8):4679-4688.

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Fujisaki K, Akasaka K, Otsudo T, Hattori H, Hasebe Y, Hall T Int J Sports Phys Ther. 2022; 17(5):841-850.

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Variation of the clavicle's muscle insertion footprints - a cadaveric study.

Herteleer M, Vancleef S, Herijgers P, Duflou J, Jonkers I, Vander Sloten J Sci Rep. 2019; 9(1):16293.

PMID: 31705003 PMC: 6841722. DOI: 10.1038/s41598-019-52845-8.

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