IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Kinemove Rehabilitation Centers, Pontremoli, Massa-Carrara, Italy -
J Sports Med Phys Fitness. 2022 Sep;62(9):1219-1227. doi: 10.23736/S0022-4707.21.12669-6.
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.
耻骨前腱膜复合结构解剖学（PPAC）由纤维囊组成，该纤维囊在耻骨联合前方排列，由不同解剖结构的连接组成。研究（原始文章、病例系列和综述文章）的检索没有出版数据限制或语言限制，在以下数据库中进行：PubMed/MEDLINE、Scopus、ISI、EXCERPTA。迄今为止，文献中的证据表明：1）PPAC 由内收肌长头、短头、大收肌和耻骨肌的肌腱、腹直肌、锥状肌和腹外斜肌腱膜、关节盘、耻骨前骨膜和上、下、前耻骨韧带之间的连接组成；2）PPAC 的临床表现可能类似于内收肌长头肌腱损伤，MRI 检查有助于区分这两种不同的临床框架；3）PPAC 损伤具有典型的 MRI 表现，必须与其他类似但临床不同的影像学框架区分开来；4）PPAC 损伤可以保守治疗，包括药物治疗或手术治疗。本叙述性综述提供了对 PPAC 解剖、临床表现、影像学和治疗的深入了解。
