An Anatomical Study of the Indirect Head of the Rectus Femoris Tendon with Clinical Applications to Arthroscopic Labral Reconstruction Surgery - The 37th Annual Meeting of the Israel Orthopaedic Association, December 13-14, 2017, Tel Aviv, Israel

Ran Atzmon ¹ Zachary T. Sharfman ² Thomas Sampson ³ Eyal Amar ² Ehud Rath ²

¹Yitzhak Shamir Medical Center, Orthopedic Department, Sackler Faculty of Medicine, Tel Aviv University, Be'er Ya'akov
²Tel Aviv Sourasky Medical Center, Orthopedic Department, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
³Post Street Surgical Center, San Francisco, California, University of California

Purpose: The purpose of this study is to describe the anatomy of the Indirect Head of the Rectus Femoris (IHRF) tendon with clinical applications to labral reconstruction surgery.

Methods: 26 formalin preserved cadaver hips were dissected. 13 measurements that have clinical relevance to arthroscopic labral reconstruction using an IHRF tendon graft were taken on each hip. All measurements were taken in triplicate, mean values, standard deviations and intra-observer reliability were calculated.

Results: The mean footprint of the direct head of the rectus femoris (DHRF) tendon was 10.57 mm x 19.59 mm. The width at the confluence of the direct and indirect heads of the rectus femoris tendon was 10.93 mm (anterior-posterior) and 6.88 mm (medial-lateral). The mean total length of the footprint and free tendon of the IHRF tendon was 55.34 mm. The cranial caudal footprint of the IHRF tendon was measured at the 12 o’clock, 1 o’clock, and 2 o’clock positions were 18.78 mm, 23.50 mm, and 24.55 mm respectively. The mean length of IHRF tendon suitable for grafting was 46.13mm and the mean number of clock face sectors covered by this graft 3.25 clock face sectors. Intra-observer reliability was ³0.90 for all recorded measurements. The origin of the IHRF on the acetabulum fans out posteriorly, becoming thinner and wider as the origin travels posteriorly. The IHRF footprint is firmly attached on the lateral wall of the ilium and becomes a free tendon overlying the acetabular bone as it travels anterior and distally towards its muscular attachment.

Conclusion: This anatomical study described the anatomy of the IHRF tendon with clinical applications to labral reconstruction surgery. The IHRF tendon is in an ideal location and possess the appropriate thickness and length to serve as a local graft source for labral reconstruction surgery.