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The Use of Botulinum Toxin in Pre-pubic Aponeurotic Complex Injuries: A Case Series.
Andrea Bisciotti1, Gian Nicola Bisciotti2, Alessio Auci3
1Department of Knee Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Journal of Orthopaedic Case Reports
|January 9, 2026
Summary
Botulinum toxin type A (BTX-A) injections effectively treat pre-pubic aponeurotic complex (PPAC) injuries, promoting healing and a rapid return to sports. This therapy shows promising results with no adverse effects observed.
Area of Science:
- Sports Medicine
- Regenerative Medicine
- Musculoskeletal Injuries
Background:
- Pre-pubic aponeurotic complex (PPAC) injuries are a common cause of groin pain, often with poor self-healing due to muscle forces.
- Botulinum toxin type A (BTX-A) has emerged as a potential therapeutic agent for these challenging injuries.
Purpose of the Study:
- To evaluate the efficacy and safety of BTX-A infiltrative therapy for treating PPAC injuries in athletes.
Main Methods:
- Ten male athletes with PPAC injuries received BTX-A injections targeting the rectus abdominis and adductor longus muscles.
- An 8-week structured rehabilitation program followed the injections.
Main Results:
- Ultrasound confirmed complete PPAC healing in 90% of subjects post-rehabilitation.
- 90% of patients returned to sports within 12 months, with 80% resuming at their previous level.
- No adverse effects were reported during the study.
Conclusions:
- BTX-A infiltrative therapy is a safe and effective treatment for PPAC injuries.
- This approach facilitates a prompt return to athletic activities.
