Operative Treatment of a Complete Rupture of the Origination of the Rectus Femoris

Abstract

A 23-year-old male athlete reported both feeling and hearing a pop in his anterior thigh while sprinting. This was followed by immediate pain and an inability to walk. He had swelling and tenderness in his inguinal region. Radiographs were normal. An magnetic resonance imaging revealed a complete avulsion of the rectus femoris from its origin on the anterior inferior iliac spine. Following discussions of his treatment options, the patient chose to undergo operative management of the injury. A surgical repair was performed of the tendon of the direct head to the anterior inferior iliac spine through bone tunnels. He had a full recovery over the next 6 months and subsequently returned to unrestricted active military duty.

Proximal Rectus Femoris Avulsion Repair

“…The most frequent treatment is nonoperative, with surgery reserved only for highactivity patients such as elite athletes or patients in whom nonoperative treatment has failed. 3,5 Reattachment with suture anchors is the gold standard for operative fixation. 2,6,7 We propose a double-row suture, as in rotator cuff repair, with 2 anchors to give more strength to the suture and prevent potential failures with early rehabilitation.…”

“…4 Although standard treatment is nonoperative management, good results have been reported with surgical treatment in a select group of patients, particularly high-level athletes. 2,3,[5][6][7][8] The purpose of this technical note is to describe the method for surgical repair of the proximal direct arm of the rectus femoris to its origin at the anterior inferior iliac spine (AIIS).…”

Avulsion of the direct head of rectus femoris following arthroscopic subspine impingement resection: a case report

“…when a kick is blocked by an opponent’s foot on the ball or direct contact with a body. This injury has also been reported in non-kicking athletes, where a sudden deceleration during sprinting has been proposed as a mechanism for injury [ 7 , 15 , 16 ]. A further mechanism of injury, as seen in this case, is hyperextension of the hip with a flexed knee.…”

“…Hasselman et al ., in a series of 10 injuries to the musculotendinous junction of the rectus, reported that only two patients underwent surgical debridement and repair [ 18 ]. Operative and non-operative treatments have been described in the high-level adult athlete [ 7 , 15 , 16 ] . Gamradt et al .…”

Nonoperative Management of a Severe Proximal Rectus Femoris Musculotendinous Injury in a Recreational Athlete: A Case Report

“…With surgical treatment, good return to play outcomes have also been described. However, the return to preinjury level of activity with surgery appears to occur within 4‐10 months [7,10‐12]. This literature indicates that surgical management may involve a longer recovery period than nonsurgical management, but it also might provide a more predictable return of strength and function [7,12].…”