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Full-Thickness Peroneus Longus Tendon Autograft Harvest
Carlos E Franciozi1,2,3, Enzo S Mameri1,4, Felipe C Schumacher1
1Department of Orthopedics and Traumatology-EPM, UNIFESP, São Paulo, Brazil.
Video Journal of Sports Medicine
|May 1, 2025
Summary
The peroneus longus (PL) autograft offers a viable alternative for anterior cruciate ligament (ACL) reconstruction, providing thicker grafts than traditional options. Further research is needed to fully understand its long-term safety and efficacy.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Traditional anterior cruciate ligament (ACL) reconstructions using bone-patellar tendon-bone, hamstring, or quadriceps tendon autografts have limitations.
- These limitations include donor site morbidity, reduced range of motion, and anterior knee pain.
- The peroneus longus (PL) autograft is explored as an alternative to overcome these challenges.
Purpose of the Study:
- To evaluate the peroneus longus (PL) autograft as an alternative graft source for anterior cruciate ligament (ACL) reconstruction.
- To compare the characteristics and outcomes of PL autografts with traditional graft options.
Main Methods:
- A surgical technique involving a longitudinal skin incision near the lateral malleolus to harvest the PL tendon is described.
- The PL tendon is isolated, tenodesed, whipstitched, and harvested using a tendon stripper.
Main Results:
- Peroneus longus (PL) autografts are generally thicker and longer compared to semitendinosus grafts.
- Demonstrated efficacy in biomechanical and clinical outcomes has been observed.
- The safety profile appears good, though some conflicting evidence regarding foot and ankle morbidity exists, with a lack of long-term follow-up data.
Conclusions:
- The peroneus longus (PL) autograft is a promising alternative for ligament reconstruction, particularly ACL reconstruction.
- While offering advantages in graft size and demonstrated efficacy, further investigation into mid- to long-term outcomes and potential donor site morbidity is warranted.
