Gracilis tendon !
The gracilis tendon is a thin tendon on the inner knee that joins the pes anserinus; it is often used as a graft to rebuild the ACL.
Official name: Tendon of gracilis
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What it is
A thin tendon on the inner knee, from the gracilis muscle. It ends on the inner tibia next to the semitendinosus.
What it does
Helps bend the knee and turn the shin inward; supports the knee from the inner side.
Key facts
- Attaches
- Pes anserinus on the upper medial tibia, between the sartorius (in front) and the semitendinosus (below)
- Function
- Knee flexion and medial rotation; hip adduction; often harvested with the semitendinosus as a hamstring graft for ACL reconstruction
- Tight in
- Hip abduction with the knee extended
Relations
- Course
- Down the medial thigh as a thin strap, becoming a round tendon above the knee; passes behind the medial femoral condyle and curves forward to the pes anserinus
- Superficial
- Sartorius aponeurosis
- Below
- Semitendinosus tendon, just below and behind it, often linked to it by fibrous bands
- Deep
- Superficial MCL, separated from it by the pes anserine bursa
How to find it
With the knee bent against resistance, two cords stand out at the back of the inner knee: the bigger, more posterior one is the semitendinosus, and the thinner one just in front of it is the gracilis; spreading the thighs apart makes the gracilis stand out more.
On imaging
On axial MRI at the knee it is a small round dark dot between the sartorius in front and the semitendinosus behind; after harvest it is missing or replaced by scar.
Common problems
- Strains or tendinitis, mostly in sports with sprinting or kicking.
- It is one of the most common graft sources for ACL reconstruction; the leg usually adapts well.
How it is diagnosed
Physical exam; ultrasound or MRI if needed.
Treatment
- Rest, ice and progressive physical therapy.
- Used as a tendon graft in ACL reconstruction.
Clinical notes
- Harvest can injure the infrapatellar branch of the saphenous nerve, leaving numbness below and in front of the knee
- After taking both the gracilis and the semitendinosus, the strength loss is mostly in deep knee flexion and is usually small
Test yourself
Think of the answer, then tap the question to see it.
Where does the gracilis tendon lie at the pes anserinus?
Between the sartorius in front and the semitendinosus below, deep to the sartorius fascia.
For which reconstructions is the gracilis tendon a common graft?
ACL reconstruction (with the semitendinosus), MPFL reconstruction and some collateral ligament reconstructions.
Between which two tendons does the saphenous nerve become subcutaneous at the medial knee?
Between the gracilis tendon and the sartorius.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- musculus gracilis TA2 2635
- Official Spanish (DeCS)
- Tendón del recto interno DeCS D013710
- English (TA2)
- Tendon of gracilis
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Bony Pelvis and Lower Limb: Thigh Gracilis Muscle.
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Representative model, for educational purposes only.
