TP7.1 OUTCOMES AFTER OPEN REPAIR OF PLAC TYPE 3 LESIONS IN ATHLETES: A CASE SERIES

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ID: 331131
2026
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Abstract
Abstract Introduction Injuries of the pyramidalis–anterior pubic ligament–adductor longus complex (PLAC) represent a distinct entity within proximal adductor pathology. PLAC type 3 lesions, as defined by Schilders et al., involve complete fibrocartilage avulsion with the Pyramidalis connected to the adductor longus and intact pectineus. Despite increasing recognition of this injury pattern, surgical technique and outcome data following surgical treatment remain limited. Purpose To report surgical technique, clinical outcomes, return to play, and structural healing following surgical treatment of PLAC type 3 lesions in athletes. Methods Twenty-five athletes (24 male, 1 female; mean age 33 years [range, 21–60]) with MRI-confirmed PLAC type 3 lesions were included. Sports included handball (n=4), tennis (n=5), swimming (n=1), golf (n=2), and soccer/futsal (n=13). Six athletes competed at a professional level and nineteen at a recreational level; the dominant limb was involved in 21 cases. Mean time from injury to surgery was 8 months (range, 2–28 months). All patients underwent open surgical repair using two individual knotless suture anchors (FiberTak 2.6 mm) to reattach the proximal adductor longus and restore the PLAC anatomy. Postoperative evaluation consisted of clinical follow-up at a mean of 1.3 years (range, 0.5–2.5 years) and control MRI at a mean of 5 months to assess structural healing. Return to play (RTP) was defined as participation in any competitive game. Results Return to play was achieved by 23 of 25 athletes (92%). One postoperative wound infection was observed and required surgical re-intervention. In all other cases, control MRI at 5 months demonstrated anatomical healing of the repaired PLAC and no reruptures or symptomatic re-avulsions occurred during follow-up. Conclusion Open surgical repair of PLAC type 3 lesions using knotless suture anchor fixation yields a high rate of return to competitive sport with reliable structural healing and a low rerupture rate. Despite a relatively long time from injury to surgery, favorable outcomes were achieved, supporting operative management as an effective treatment option for symptomatic PLAC type 3 injuries in athletes.
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Authors Frans-Jozef Vandeputte, Abner Sergooris, MD Wouter Peeters, Stijn Roose
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.168
URL
https://doi.org/10.1093/jhps/hnag043.168
Keywords Keywords not found

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