Peroneus longus autograft can be recommended as a superior graft to hamstring tendon in single-bundle ACL reconstruction

Abstract

Purpose A peroneus longus tendon autograft is used in many orthopaedic procedures and it is biomechanically comparable to a hamstring tendon autograft. Despite its potential, there are few studies that have evaluated the use of the peroneus longus tendon in ACL reconstruction. The aim of this study was to compare the clinical outcome and donor site morbidity of ACL reconstruction with hamstring tendon autografts versus peroneus longus tendon autografts in patients with an isolated ACL injury. Methods Patients who underwent isolated single-bundle ACL reconstruction were allocated to two groups (hamstring and peroneus longus) and observed prospectively. Graft diameter was measured intraoperatively. Functional scores (IKDC, modiied Cincinnati and Lysholm scores) were recorded preoperatively and 1 year after surgery. Donor site morbidities were assessed with thigh circumference measurements and ankle scoring with the AOFAS and FADI. Results Fifty-two patients (hamstring n = 28, peroneus n = 24) met the inclusion criteria. The peroneus longus graft diameter (8.8 ± 0.7 mm) was signiicantly larger than the hamstring diameter (8.2 ± 0.8 mm) (p = 0.012). There were no signiicant diferences between the pre-and 1-year postoperative score between the hamstring and peroneus longus groups in the IKDC (n.s), modiied Cincinnati (n.s), and Lysholm (n.s). The mean for the AOFAS was 97.3 ± 4.2 and for the FADI 98 ± 3.4 in the peroneus longus group, with a signiicant decrease in thigh circumference in the hamstring group (p = 0.002). Conclusion Anterior cruciate ligament reconstruction with peroneus longus autografts produces a functional score (IKDC, modiied Cincinnati, Lysholm) comparable to that of hamstring autografts at a 1-year follow-up, with the advantages of larger graft diameter, less thigh hypotrophy and excellent ankle function based on AOFAS and FADI scores. Level of evidenceProspective cohort study, Level II. Abbreviations ACL Anterior cruciate ligament BPTB Bone-patellar tendon-bone MPFL Medial patellofemoral ligament IKDC International Knee Documentation Committee MCL Medial collateral ligament * Nicolaas C. Budhiparama

Lateral Meniscus Replacement Using Peroneus Longus Tendon Autograft

“…There is a potential risk of morbidity at the donor site, and although there is the theoretical possibility of peroneus nerve injury, limp, or collapsed arch, Rhatomy et al. 5 and Shi et al. 6 have described that the frequency of complications is low with this technique.…”

“…Autografts of the peroneus longus tendon are becoming popular in knee surgery for reconstruction of the anterior cruciate ligaments (ACLs) and posterior cruciate ligaments. 4 , 5 , 6 In this report, we aimed to describe a meniscus-replacement technique, using a peroneus longus tendon graft, for lateral meniscus deficits. To optimize the surgical technique, we adapted some steps from shoulder surgery.…”

The influence of hamstring autograft diameter on patient- reported functional scoresfollowing anterior cruciate ligament (ACL) reconstruction

“…Allograft options include all of them in addition to tibialis and achilles tendon. 10,11 Single-bundle ACL reconstruction with hamstring autograft can use only semitendinosus tendon (ST), or combination with the gracilis tendon. 12 Some studies reported that hamstring autograft can reduce the failure rate after ACL reconstruction 13 and only the semitendinosus and gracilis auto graft was able to reproduce the native size of the ACL footprint on the femoral side.…”

Advances and trends in multiligament injuries of the knee relevant to low-resource settings

“…Recently, the use of peroneus longus [ Figure 6] as an autograft option was reported as an acceptable option for anterior cruciate ligament (ACL), PCL, and PLC reconstructions. [32,33] Allografts have been used successfully for MLKIs, which eliminates donor site morbidity and reduces operating time. [31] However, there is an increased risk for disease transmission, increased cost, limited availability in many areas, and higher failure rates when irradiated grafts are used.…”