The gracilis tendon is the middle component of the pes anserinus on the medial tibia, identifiable between the sartorius (anterior) and semitendinosus (posterior) during resisted knee flexion. As the most expendable leg muscle with no unique function that cannot be compensated, its tendon is harvested for facial reanimation, urological reconstruction, and occasionally ACL reconstruction alongside the semitendinosus.
Knee flexion and hip adduction force transmission; pes anserinus medial knee stability
The gracilis tendon is the preferred tendon for facial reanimation free muscle transfer because its harvested length provides adequate reach from the masseter or facial nerve to the oral commissure, and its loss produces no detectable weakness. Its pes anserinus contribution to medial knee stability means that gracilis harvest can marginally increase medial knee laxity in some patients, but this is clinically insignificant in most cases.
Medial tibial pain at the pes anserinus harvest site after gracilis or semitendinosus graft for ACL reconstruction, usually resolving within 3 to 6 months.
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