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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.
Introduction:
Injuries of the pre-pubic aponeurotic complex (PPAC) are a significant cause of groin pain syndrome. These injuries tend to have limited self-healing capacity because the injured area is kept apart by opposing forces exerted by the rectus abdominis (RA) and adductor longus muscles. Recently, botulinum toxin type A (BTX-A) has been successfully used in a case report describing a patient with PPAC injuries. This study aims to evaluate the efficacy of BTX-A in a series of patients with PPAC injuries.
Materials And Methods:
Ten male athletic subjects with PPAC injuries underwent infiltrative therapy with BTX-A at the level of the RA and adductor longus, followed by an 8-week rehabilitation program.
Results:
Ultrasound assessment performed after the rehabilitation program showed that 9 subjects (90%) achieved complete restitutio ad integrum of the PPAC injury area, while 1 subject (10%) exhibited partial repair. At 12 months of follow-up, 9 patients (90%) returned to sports activity, 8 (80%) at the same level, and 1 (10%) at a lower level, but not due to residual pain. No adverse effects were recorded.
Conclusion:
BTX-A infiltrative therapy appears to be a safe, effective, and promising treatment for PPAC injuries, enabling a quick return to sporting activity.
