Peroneus Longus Tendon Autograft: A Promising Graft for ACL Reconstruction.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomaterials Science

Background:

• Hamstring tendon autografts for anterior cruciate ligament (ACL) reconstruction present donor site complications.
• An alternative autograft with sufficient strength and reduced donor site morbidity is needed.
• The peroneus longus tendon is identified as a promising alternative graft option.

Purpose of the Study:

• To evaluate the efficacy and safety of using the peroneus longus tendon as an autograft for primary ACL reconstruction.
• To compare the outcomes of peroneus longus tendon autografts with traditional hamstring tendon autografts.
• To assess donor site morbidity and graft characteristics.

Main Methods:

• Harvesting the peroneus longus tendon via a specific incision technique near the lateral malleolus.
• Performing tendon division and end-to-side suture with the peroneus brevis tendon.
• Utilizing a tendon stripper for proximal harvesting to avoid peroneal nerve injury.
• Standard graft preparation and fixation using cortical suspension devices, bioabsorbable screws, or combined techniques for arthroscopic ACL reconstruction.

Main Results:

• Peroneus longus autografts demonstrated comparable outcomes to hamstring autografts at 1-year follow-up in primary ACL reconstruction.
• Graft diameter was larger with peroneus longus autografts, and thigh hypotrophy was reduced.
• Excellent functional outcomes were reported, with high AOFAS-Hindfoot and FADI scores (97.3 ± 4.2 and 98 ± 3.4, respectively).

Conclusions:

• Peroneus longus tendon autograft is a safe procedure for primary ACL reconstruction with excellent outcomes.
• It can be recommended as a viable alternative graft for single-bundle ACL reconstruction.
• Further research is recommended to evaluate long-term functional outcomes and knee stability.