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Reflected Head of Rectus Femoris Tendon

tendo capitis reflexi musculi recti femoris

The rectus femoris has two proximal tendinous origins: the direct head (from the anterior inferior iliac spine, AIIS) and the reflected head (from a groove on the ilium just above the acetabular rim, the supraacetabular groove). The reflected head is clinically significant as it passes directly over the anterior hip capsule and acetabular rim, making it a landmark and potential pain generator in hip impingement and a target in hip arthroscopic surgery.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

The reflected head of rectus femoris is routinely encountered during hip arthroscopy in the central compartment, where it forms a visible landmark over the anterior acetabular rim. In patients with anterior hip pain, the reflected head may be inflamed or partially avulsed in high-velocity deceleration injuries (footballer's hip). Tenotomy or partial release of the reflected head is performed arthroscopically when it contributes to anterior hip impingement or when additional acetabular rim access is required during labral repair. In open hip preservation surgery (Bernese periacetabular osteotomy), the reflected head is elevated to access the hip capsule anteriorly.

Pathology

Common Injuries & Conditions

Reflected Head Rectus Femoris Avulsion in High-Energy Hip Injury

Explosive deceleration or kicking injuries can avulse the reflected head of rectus femoris from its supraacetabular groove origin, producing anterior hip pain and visible avulsion fragment on radiograph or MRI near the acetabular rim; small fragments are managed conservatively while large avulsions with functional deficit require fixation.