Proximal Rectus Femoris Avulsion Repair

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Presentation transcript:

Proximal Rectus Femoris Avulsion Repair Chase S. Dean, M.D., Lucas Arbeloa-Gutierrez, M.D., Jorge Chahla, M.D., Cecilia Pascual-Garrido, M.D.  Arthroscopy Techniques  Volume 5, Issue 3, Pages e545-e549 (June 2016) DOI: 10.1016/j.eats.2016.02.002 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Coronal T2-weighted magnetic resonance image showing an avulsion of the left direct head of the rectus femoris (arrow) from the anterior inferior iliac spine. The contralateral (right) direct head of the rectus femoris is intact and remains attached to the anterior inferior iliac spine. Arthroscopy Techniques 2016 5, e545-e549DOI: (10.1016/j.eats.2016.02.002) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Axial magnetic resonance imaging cut showing the left rectus femoris tendon (direct head) avulsed from the anterior inferior iliac spine (arrow). Arthroscopy Techniques 2016 5, e545-e549DOI: (10.1016/j.eats.2016.02.002) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Pertinent landmarks for the Smith-Petersen approach shown on a left hip. The thick solid line represents the planned incision, and the thinner solid line represents a rough outline of the greater trochanter (GT). The dotted line represents the relationship between the GT and the anterior superior iliac spine (ASIS). Arthroscopy Techniques 2016 5, e545-e549DOI: (10.1016/j.eats.2016.02.002) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 (A) Cadaveric dissection showing the lateral femoral cutaneous nerve (LFCN) crossing over the sartorius 2 to 4 cm distal to the anterior superior iliac spine (ASIS). (B) The Smith-Petersen approach is performed through the interval between the tensor fascia lata (TFL) and the sartorius. The fascia of the rectus can be observed deep to the TFL and sartorius. Arthroscopy Techniques 2016 5, e545-e549DOI: (10.1016/j.eats.2016.02.002) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Cadaveric image of the proximal insertion of the rectus femoris. One should note how the direct arm attaches to the anterior inferior iliac spine (AIIS) and how the indirect arm has a broader insertion that attaches to the superior acetabular ridge. Arthroscopy Techniques 2016 5, e545-e549DOI: (10.1016/j.eats.2016.02.002) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 The direct arm of the proximal rectus femoris tendon is shown with mobilization sutures placed through it, and the surgeon's finger is pointing at the anterior inferior iliac spine (AIIS). Arthroscopy Techniques 2016 5, e545-e549DOI: (10.1016/j.eats.2016.02.002) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions