Gracilis tendon harvesting using the posterior approach for anatomical ankle ligament reconstruction: A rapid and reliable technique with minimal neurological complications.

PURPOSE: To report donor site morbidity following gracilis harvesting using a posterior approach for anatomic ankle ligament reconstruction. METHODS: Between January 2023 and March 2025, 33 patients underwent anatomic ankle ligament reconstruction with a gracilis autograft for chronic ankle instability. In 2 patients, it was not possible to harvest the gracilis due to obesity, leaving 31 patients for assessment. RESULTS: The remaining 31 patients comprised 12 males, and 19 females, were aged 36.8 ± 12.6 (range, 17-60) with a BMI of 27.1 ± 4.4 (range, 18-37). Of the 31 patients, the gracilis was harvest with the knee flexed in 30 (97%), and knee extended in 1 (3%). At a follow-up of 5.1 ± 3.8 months, 1 patient reported neuropathy of the saphenous nerve, and 5 reported discomfort around the donor-site, which resolved in 3. CONCLUSION: Gracilis harvesting using the posterior approach is a safe technique with minimal complications and donor-site morbidity.