The 'Motionless Gastrocnemius': A Reliable Sign for Safe Graft Harvesting

Difficulties in graft harvesting of the hamstring have been the topic of many studies. These difficulties are related to the aponeurotic or fibrous attachments of the hamstrings with the medial head of the gastrocnemius muscle, soleus muscle, and leg fascia. Freeing the graft from these attachments is important because insufficient release prior to stripper insertion can lead to premature transection or amputation. We describe a reliable intraoperative physical examination sign to help understand the sufficient amount by which a tendon graft needs to be released prior to stripper insertion. The presence of the motionless gastrocnemius (“motionless gastroc”) phenomenon is used in our clinic as a sign that the grafts have been sufficiently freed and that a tendon stripper can be used without fear of transection or graft amputation.