The gracilis tendon inserts as the middle component of the pes anserinus on the medial tibia, providing dynamic medial knee stabilisation alongside the sartorius and semitendinosus. The gracilis tendon is the most commonly harvested graft for ACL and PCL reconstruction — its long, uniform diameter (3-4 mm × 20-22 cm) makes it ideal for quadrupled graft preparation. Harvest is performed through a small medial tibial incision with a tendon stripper.
Knee flexion and internal rotation of tibia; medial dynamic knee stabiliser in the pes anserinus complex
Gracilis tendon harvest for ACL reconstruction is performed through a 3-cm incision over the pes anserinus 2 cm distal and 2 cm medial to the tibial tuberosity. The gracilis is identified posterior to the sartorius tendon and anterior to the semitendinosus. The four-strand gracilis-semitendinosus graft achieves a cross-sectional area approaching that of the native ACL.
Gracilis tendon harvested with semitendinosus as a four-strand graft for ACL reconstruction — the most commonly used autograft in contemporary ACL surgery.
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