The adductor magnus has two distinct portions with separate tendons: the adductor portion inserts on the medial lip of the linea aspera and medial supracondylar line, while the hamstring portion (the ischiocondylar part) forms a strong rounded tendon that inserts on the adductor tubercle of the medial femoral condyle. Between the two portions lies the adductor hiatus, a tendinous opening through which the femoral vessels pass from the adductor canal into the popliteal fossa.
The adductor canal tendon insertion on the adductor tubercle is the site of adductor magnus tendinopathy, a recognised but underdiagnosed cause of medial knee pain in athletes, often misattributed to MCL pathology or pes anserinus bursitis. The adductor hiatus through which the femoral artery becomes the popliteal artery is the site where Hunter canal compression produces occlusion in popliteal artery entrapment syndrome type IV. The adductor tubercle avulsion fracture is an equivalents of the adductor magnus hamstring portion tear.
Insertional tendinopathy at the medial femoral condyle produces medial knee pain reproduced by palpation of the adductor tubercle and resisted hip adduction in near-full extension, managed with progressive loading exercises and injection.
Type IV popliteal artery entrapment syndrome involves compression of the popliteal artery by the adductor hiatus tendinous band during knee extension and active plantarflexion, producing exercise-induced calf claudication in young athletes, requiring surgical release of the compressing tendinous band.
