{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:50:55Z","timestamp":1792083055790,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This narrative review synthesises the anatomical, biomechanical, and clinical evidence on the rectus femoris tendon as an autograft for knee ligament reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted in PubMed and Google Scholar up to June 2026 with no language restrictions. A total of 35 articles describing the rectus femoris tendon as a graft for knee ligament reconstruction were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cadaveric studies demonstrated consistent morphometric dimensions, with a mean tendon length of approximately 30\u2009cm and graft diameters ranging from 8 to 11\u2009mm. Biomechanical testing across four independent cadaveric studies showed that the doubled rectus femoris provides load\u2010to\u2010failure within the range of established anterior cruciate ligament grafts. Multiple harvesting techniques have been described, using the identification of a fat layer between the rectus femoris and the intermediate layer as the primary landmark. The graft has been applied to isolated anterior cruciate ligament reconstruction, combined anterior cruciate ligament and anterolateral or anteromedial ligament reinforcement, posterior cruciate ligament reconstruction, and revision surgery. Early clinical series reported functional outcomes comparable to hamstring tendon autografts, with low donor\u2010site morbidity. Isokinetic evaluation showed no difference in extensor performance between rectus femoris and hamstring tendon groups at six months. Intraoperative complications included capsular violations and premature graft amputations, concentrated in initial cases and without clinical repercussions. The current clinical evidence is limited to level III and IV studies, with a maximum mean follow\u2010up of approximately 3.5 years in revision settings and 3 years in primary reconstruction, demonstrating improvement in patient\u2010reported outcomes and knee stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The rectus femoris tendon is a viable autograft for knee ligament reconstruction, with consistent anatomy, adequate biomechanical properties, and early clinical results comparable to hamstring tendon autografts. It should be considered in individualised graft selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70862","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:15:16Z","timestamp":1785410116000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Beyond the quadriceps tendon: The rectus femoris as a distinct autograft for knee ligament reconstruction\u2014A narrative review"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8447-7660","authenticated-orcid":false,"given":"Bernardo Garcia","family":"Barroso","sequence":"first","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Vit\u00f3ria Apart Hospital Serra Esp\u00edrito Santo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8499-8659","authenticated-orcid":false,"given":"Marcelo","family":"Cabral Fagundes R\u00eago","sequence":"additional","affiliation":[{"name":"Grupo de Joelho, Hospital Memorial S\u00e3o Francisco Natal Rio Grande do Norte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2755-9969","authenticated-orcid":false,"given":"M\u00e1rcio","family":"Cabral Fagundes R\u00eago","sequence":"additional","affiliation":[{"name":"Grupo de Joelho, Hospital Memorial S\u00e3o Francisco Natal Rio Grande do Norte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8195-0036","authenticated-orcid":false,"given":"Felipe Silveira","family":"Martins","sequence":"additional","affiliation":[{"name":"Grupo do Joelho, Cl\u00ednica de Ortopedia e Traumatologia Balne\u00e1rio Cambori\u00fa Santa Catarina Brazil"},{"name":"Hospital da Unimed Balne\u00e1rio Cambori\u00fa Santa Catarina Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1339-4785","authenticated-orcid":false,"given":"Sergio","family":"Marinho de Gusm\u00e3o Canuto","sequence":"additional","affiliation":[{"name":"Ortocl\u00ednica Hospital de Ortopedia Macei\u00f3 Alagoas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1554-7514","authenticated-orcid":false,"given":"Marcos Barbieri","family":"Mestriner","sequence":"additional","affiliation":[{"name":"Departamento de Ortopedia e Traumatologia Grupo de Joelho, Santa Casa de S\u00e3o Paulo S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0932-6870","authenticated-orcid":false,"given":"Carlos Eduardo","family":"Franciozi","sequence":"additional","affiliation":[{"name":"Departamento Ortopedia da Escola Paulista Medicina UNIFESP S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-2524","authenticated-orcid":false,"given":"Camilo Partezani","family":"Helito","sequence":"additional","affiliation":[{"name":"Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ars2.70024"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2024.103067"},{"issue":"5","key":"e_1_2_11_4_1","first-page":"1027","article-title":"The rectus femoris tendon graft for ACL reconstruction: predictive anthropometry and surgical pearls based on a prospective case series","volume":"54","author":"Barroso BG","year":"2026","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-020-00261-7"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2025.103460"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.25259\/JASSM_29_2025"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2025.103845"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.17816\/vto702650"},{"issue":"10","key":"e_1_2_11_10_1","article-title":"Evaluation and management of knee dislocations in low\u2010income settings: evidence\u2010based strategies and practical considerations","volume":"9","author":"Helito CP","year":"2025","journal-title":"J Am Acad Orthop Surg. 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