Related Experiment Video
Updated: Mar 12, 2026
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Peroneus longus provides a thicker and longer graft with comparable outcomes to semitendinosus in All-Inside ACL
Nitesh Gahlot1, Aakash Chaudhary2, Manveer Singh Dhillon2
1All India Institute of Medical Sciences Jodhpur, Jodhpur, India. doc.nitesh@gmail.com.
Background:
The Peroneus longus graft has not been assessed till now in All-Inside Anterior Cruciate Ligament Reconstruction (AI-ACLR). The purpose of this study was to compare the PLT and STT autograft in terms of graft characteristics (e.g. graft diameter, length, etc.) as primary outcome and clinical scores (IKDC, Tegner-lysholm and KOOS scores) as secondary outcomes in AI-ACLR using our modified surgical technique.
Materials And Methods:
This retrospective, non-randomised case-control study was conducted from January 2021 to October 2023. Patients with ACL tears, aged between 18 and 50 years, were included. Patients having multiligament injuries, fractures, meniscal injuries, pre-existing osteoarthritis of the knee or a BMI of ≥30 kg/m2 were excluded. Patients were non-randomly divided into two groups according to autograft source. Group 1: PLT; Group 2: STT. 70 patients underwent AI-ACLR using our modified technique: Group 1, n = 35; Group 2, n = 35. Mean follow-up duration was 24 ± 3.4 (range 18-28) months.
Results:
Mean age was 28 (17-36) years. The harvested tendon length was significantly longer in group 1 (31.51 ± 2.41 mm vs. 29.0 ± 2.49 mm; P = 0.004). Group 1 also had significantly thicker graft diameter (8.9 ± 0.16 mm vs. 8.1 ± 0.3 mm; P = 0.021), longer graft (69.74 ± 1.54 mm vs. 68.18 ± 2.52 mm; P = 0.039), better followup KOOS (68.86 ± 6.1 vs. 60.09 ± 5.65; P < 0.001), Tegner-Lysholm score (69.46 ± 4.62 vs. 65.73 ± 6.25; P = 0.038) and IKDC score (59.26 ± 3.81 vs. 56.18 ± 5.65; P = 0.045). The mean surgical time was slightly less in group 1 (59.89 ± 9.32 min vs. 61.64 ± 6.82 min), but the difference was not statistically significant (P = 0.506).
Conclusion:
Our modified technique of AI-ACLR using Peroneus longus (PLT) provides better graft characteristics for AI-ACLR as compared to Semi-tendinosis (STT). The functional outcome scores were comparable in both the groups with no major complications reported, at a mean of 24 months of follow-up.
Level Of Evidence Iii:
(Retrospective comparative study).
