Rectus femoris transfer - Gracilis versus sartorius

In order to determine the effectiveness of a new technique of rectus femoris transfer and to compare the effectiveness between the two transfer sites (gracilis versus sartorius), we evaluated the results of pre- and post-operative gait analyses in 46 limbs in 35 cerebral palsy patients who had been treated with the rectus femoris transfer either to the gracilis (gracilis group) or to the sartorius (sartorius group). Preoperatively, there were no significant differences between the two groups in any of the parameters measured. Post-operatively there were significant improvements in stride length, dynamic knee range of motion (ROM), knee angle at initial contact, and maximum knee extension in stance in both groups (P < 0.05). The improvement of dynamic knee ROM was more significant in the gracilis group (11.3 degrees) than in the sartorius group (5.0 degrees). Postoperatively maximum knee flexion in swing increased significantly in the gracilis group (P < 0.05), but not in the sartorius group. Overall results indicated that the transfer of the rectus femoris to the gracilis by the technique currently used was better than that to the sartorius.