Abstract
An anatomical variant of the pes anserinus encountered during anterior cruciate ligament reconstructive surgery which has not been previously described is discussed. During routine harvesting, the sartorius fascia was incised and the semitendinosus and gracilis tendons were identified. At the distal portion, it was noted that each tendon gave off an additional tendinous slip. The slip from the semitendinosus tendon had attached to the gracilis tendon and vice versa, thereby creating a double pes anserinus. This variant was used to construct the graft, and at 1 year review the patient had returned to full sporting activities with no complications encountered.
Highlights
Rupture of the anterior cruciate ligament (ACL) is a common sporting injury with an annual incidence of 1 in 3,000 in the USA [1]
We report a case of a previously undescribed anatomical variant of the pes anserinus that had implications for tendon harvesting and preparation at ACL reconstruction in a young female
Surgery involving the pes anserinus has long been associated with ACL injuries
Summary
Rupture of the anterior cruciate ligament (ACL) is a common sporting injury with an annual incidence of 1 in 3,000 in the USA [1]. The gracilis and semitendinosus tendons lie posterior and deep to this layer but superficial to layer II, which is composed of the superficial medial ligament and variable structures anterior to this ligament. Layer III, which is made up of the capsule of the knee joint and the deep medial ligament, is not routinely encountered in ACL surgery. It is the senior author’s experience that there is significant rarity in finding variations of the pes anserinus that affect clinical practice. We report a case of a previously undescribed anatomical variant of the pes anserinus that had implications for tendon harvesting and preparation at ACL reconstruction in a young female
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