Rectus Femoris Tendon Harvesting: Step-by-Step Open Technique

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Rectus femoris tendon autograft is a viable alternative to hamstring and patellar tendon grafts.
• It offers a thick, robust graft with minimal donor-site morbidity and predictable dimensions.
• This graft potentially minimizes postoperative quadriceps weakness due to its consistent anatomy.

Purpose of the Study:

• To describe a technique for harvesting the rectus femoris tendon autograft.
• To evaluate its suitability for ligament reconstructions, including combined ACL and ALL reconstructions.
• To assess graft quality and impact on quadriceps strength.

Main Methods:

• A 3-4 cm vertical incision is made over the lateral quadriceps tendon proximal to the patella.
• A 10 mm-wide strip of rectus femoris tendon is harvested, yielding a 30-35 cm graft.
• The technique was applied in 25 patients undergoing combined ACL and ALL reconstruction.

Main Results:

• The technique consistently provided adequate graft diameter and length for single- or double-bundle reconstructions.
• No graft-harvesting-related complications were observed in the 25 patients.
• Isokinetic dynamometry showed no clinically relevant quadriceps strength deficit at 6 months postoperatively.

Conclusions:

• The rectus femoris tendon autograft technique is safe, reproducible, and yields high-quality grafts.
• It preserves quadriceps strength, making it a dependable option for primary and revision ligament reconstructions.
• Favorable structural characteristics and absence of functional deficits support its use.