Three-Dimensional Muscle-Tendon Geometry after Rectus Femoris Transfer

Introduction Rectus femoris transfer surgery is performed to improve knee flexion in persons with cerebral palsy who walk with a stiff-knee gait (Gage et al., 1987; Perry, 1987). In this surgery, the rectus femoris muscle is separated from the quadriceps tendon, tunneled through the subcutaneous tissue on the medial aspect of the thigh and sutured to one of the knee flexors – such as sartorius or semitendinosus. Sutherland (1990) showed knee flexion improved when rectus femoris transfer alone was performed. Other investigators have shown that knee flexion improves when rectus femoris transfer is performed in conjunction with other surgeries (Miller et al. 1997). The conceptual basis for these improvements after rectus femoris transfer is (i) removal of the rectus femoris as a knee extensor and (ii) conversion of the rectus femoris to a knee flexor.