SciCombinator

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Concept: Adductor longus muscle

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BACKGROUND:Chronic adductor enthesopathy is a well-known cause of groin pain in athletes. Currently, percutaneous nonselective adductor tenotomies give mixed results and not always predictable outcomes. HYPOTHESIS:A selective partial adductor longus release as treatment for recalcitrant chronic adductor longus enthesopathy provides excellent pain relief with a prompt and consistent return to preinjury levels of sport. STUDY DESIGN:Case series; Level of evidence, 4. METHODS:All athletes were assessed in a standard way for adductor dysfunction. They received radiographs and a specifically designed magnetic resonance imaging groin study protocol. Only professional athletes who received a selective partial adductor release were included. Pain and functional improvement were assessed with the visual analog scale (VAS) pain score and time to return to sport. RESULTS:Forty-three professional athletes (39 soccer and 4 rugby) with chronic adductor-related groin pain were treated with a selective partial adductor release. The average follow-up time was 40.2 months (range, 25-72 months). Forty-two of 43 athletes returned to their preinjury level of sport after an average of  9.21 weeks (range, 4-24 weeks; SD, 4.68 weeks). The preoperative VAS score improved significantly (Wilcoxon signed-rank test, P < .001) from 5.76 ± 1.08 (range, 3-8) to 0.23 ± 0.61 (range, 0-3) postoperatively. CONCLUSION:A selective partial adductor longus release provides excellent pain relief for chronic adductor enthesopathy in professional athletes with a consistent high rate of return to the preinjury level of sport.

Concepts: X-ray, Medical imaging, Nuclear magnetic resonance, Radiography, Magnetic resonance imaging, Rate of return, Professional sports, Adductor longus muscle

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Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneath the insertions of symphysial joint capsule and adductor longus tendon. Little is known about this apophysis and its response to chronic stress.

Concepts: Medicine, Stress, Pubis, Peroneus longus, Mons pubis, Adductor longus muscle

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The role of (18)F-fluorodeoxyglucose positron emission computed tomography ((18)F-FDG PET/CT) is increasing in the diagnosis of polymyalgia rheumatica (PMR), one of the most common inflammatory rheumatic diseases. In addition to other locations, increased (18)F-FDG accumulation has been detected in the praepubic region in some patients. However, a deeper description and pathophysiological explanation of this increased praepubic accumulation has been lacking. The aim of the presented study is to confirm a decrease in praepubic (18)F-FDG accumulation in response to therapy and to describe potential correlations to other (18)F-FDG PET/CT scan characteristics during the course of disease. As a secondary objective, we describe the pathological aspects of the observed praepubic (18)F-FDG uptake.

Concepts: Medicine, Medical imaging, Rheumatology, Femoral triangle, Polymyalgia rheumatica, Thigh muscles, Remitting seronegative symmetrical synovitis with pitting edema, Adductor longus muscle

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Acute adductor longus ruptures occur infrequently and have been rarely described in the literature. Schlegel et al. reviewed a series of adductor longus tendon ruptures and found that all ruptured proximally. A 42-year-old man with right hip pain 3 weeks following a skiing injury underwent magnetic resonance imaging (MRI), which demonstrated a distal adductor longus avulsion. The diagnosis of acute adductor longus injury can be difficult on physical examination alone, but MRI can accurately depict the site of injury. Surgery may be indicated for a proximal avulsion, but a distal injury may heal with nonoperative treatment, as in our case.

Concepts: Medical imaging, Nuclear magnetic resonance, Magnetic resonance imaging, Hip, Adductor longus muscle

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The purpose of the present study was to characterise the relationship between relative versus absolute internal and external loads in collegiate basketball players throughout the course of a season. Five Division I basketball players wore triaxial accelerometers throughout the 2015-2016 season and were tensiomyographically assessed weekly. One-way repeated-measure analysis of variance (RM ANOVA) with least-significant-difference (LSD) pairwise comparisons was used to determine which absolute weekly loads were different across the season. Cohen’s d was used to supplement the determination of meaningful relative load changes. Overall RM ANOVA models suggest absolute external load differences occurred (PlayerLoad™ F = 17.63; IMA™ F = 31.63). Two-way RM ANOVA models revealed main effect differences were revealed between muscle groups for Tc (F = 9.11) and Dm (F = 3.25). Meaningful relative load changes between weeks were observed for both external and internal. The present study observed that tensiomyography utilised as a tool to monitor internal load may be more suitable for detecting fatigue from relative external load changes versus absolute load attained. Limiting weekly training volume changes to ≤10% may maintain appropriate adaptation. Mediolateral plane IMA™ and adductor longus muscle group may be pertinent metrics when monitoring female collegiate basketball athletes.

Concepts: Variance, Muscle, Normal distribution, Analysis of variance, Femoral triangle, Thigh muscles, Adductor longus muscle, College basketball

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To report thigh muscle magnetic resonance imaging (MRI) tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor enthesopathy.

Concepts: Spin, Muscle, Nuclear magnetic resonance, Magnetic resonance imaging, Adductor longus muscle

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Reconstruction of the perineum is required following oncological resections. Plastic surgical techniques can be used to restore the aesthetics and function of the perineum. The gracilis myocutaneous flap provides a substantial skin paddle, with minimal donor site morbidity. The flap is pedicled on a perforator from the medial circumflex femoral artery, giving it limited reach across the perineum. Tunnelling the flap under the adductor longus muscle may free up more of the arterial pedicle, increasing its reach. On three female cadavers, bilateral gracilis flaps were raised in the standard surgical manner, giving six flaps in total. With the flaps pedicled across the perineum, the distance from the tip of each flap was measured to the anterior superior iliac spine (ASIS). The flaps were then tunnelled under the adductor longus muscle. The distances to the ASIS were measured again. The average pedicle length was greater than 7 cm. Tunnelling the flap under the adductor longus muscle increased the reach by more than 4 cm on average. Cadaveric dissection has shown that tunnelling of the flap in a novel way increase its reach across the perineum. This additional flexibility improves its use clinically and is of benefit to plastic surgeons operating in perineal reconstruction.

Concepts: Surgery, Distance, Perineum, Femoral triangle, Anterior superior iliac spine, Gracilis muscle, Thigh muscles, Adductor longus muscle

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Only a few cases of adductor longus tendon ruptures have been reported in the literature and - there are no clear criteria for conservative or surgical treatment. A case of traumatic rupture of the right distal adductor longus tendon is presented in an elite soccer player, which was surgically repaired. The condition was managed conservatively primarily. However, after 2 months, a palpable mass remained on the medial side of the thigh, and the patient had pain after moderate everyday load and insufficient strength of the right leg during physical exercise. It was decided to explore ruptured tendon surgically and reattach to the femur. Full function of the right leg was achieved at 3 months after surgical repair. At 6 months postoperatively, the patient had returned to soccer at the same level.

Concepts: Muscle, Right-wing politics, Conservatism, Political spectrum, Human leg, French Revolution, Liberalism, Adductor longus muscle

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To assess the outcome of nonoperative treatment after complete avulsion of the proximal adductor longus tendon in high-performance athletes.

Concepts: Peroneus longus, Thigh muscles, Adductor longus muscle

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The use of low-level laser therapy (LLLT) represents a new intervention modality that has been explored to enhance exercise performance. The aim of this study was to evaluate the influence of LLLT (GaAIAs-850 nm) at different doses on VO2max and on exercise performance in rats. Male Wistar rats were divided into three groups: “placebo” rats (P-LLLT, n = 10), rats at a dose of 0.315 J per treatment point of LLLT (8.7 J/cm(2)-LLLT, n = 10), and rats at a dose of 2.205 J per treatment point of LLLT (61.2 J/cm(2)-LLLT, n = 10). The LLLT was applied bilaterally at the biceps femoris, gluteus, lateral and medial gastrocnemius, iliopsoas, and adductor longus muscles. One spot in each muscle belly was applied, with a sum of 12 spots in each rat, once a day, for 10 days. All animals performed the maximal exercise test (ET) at a metabolic treadmill for rats, with simultaneous gas analysis. The distance covered was measured during ET, before and after the conclusion of the LLLT protocol. The data were compared by a repeated measures two-way ANOVA followed by the Student-Newman-Keuls post hoc tests (p < .05). The 61.2 J/cm(2)-LLLT group increased VO2basal (~40 %), VO2max (~24 %), VCO2max (~17 %), and distance covered (~34 %) after LLLT application on the skeletal muscle. No significant results were found comparing before and after conditions for the studied variables considering P-LLLT and 8.7 J/cm(2)-LLLT groups. The LLLT promoted in a dose-dependent manner an increase in oxygen consumption uptake and a performance increment of male Wistar rats.

Concepts: Muscle, Low level laser therapy, Exercise physiology, VO2 max, Physical fitness, Laser medicine, Thigh muscles, Adductor longus muscle