The adductor magnus is the largest and most powerful adductor, composed of two functionally distinct parts with different nerve supplies. The adductor hiatus — the gap in the adductor magnus membrane between its two parts — transmits the femoral artery and vein into the popliteal fossa and the saphenous nerve as it exits to the medial leg. Compression of the saphenous nerve at the adductor canal (Hunter's canal) produces the medial knee and leg pain of adductor canal syndrome.
| Origin | Inferior pubic ramus and ischial ramus; Ischial tuberosity — this head is supplied by the sciatic nerve and acts as an additional hamstring |
|---|---|
| Insertion | Entire linea aspera and medial supracondylar ridge; Adductor tubercle of the medial femoral condyle — the primary static attachment |
| Nerve Supply | Adductor part: obturator nerve (L2, L3, L4); Hamstring part: tibial division of sciatic nerve (L4) |
| Blood Supply | Deep femoral artery perforators and geniculate arteries |
| Actions | Hip adduction (primary for both parts); Hip extension (hamstring part); The adductor hiatus in the membrane between its two parts transmits the femoral vessels to the popliteal fossa |
|---|
Adductor canal syndrome from saphenous nerve compression between the vastus medialis and adductor magnus membranes produces medial knee and leg paraesthesia exacerbated by knee extension. Injection and surgical adductor canal release resolve most cases. Distal adductor magnus insertional tendinopathy at the adductor tubercle produces the medial knee pain of distal adductor tendinopathy.
The adductor magnus is palpable as the bulk of the medial posterior thigh, with the adductor tubercle insertion palpable at the medial femoral condyle just proximal to the medial joint line.
Saphenous nerve compression at the adductor hiatus producing medial knee and leg paraesthesia managed with canal injection and surgical decompression.
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