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Updated: Jun 2, 2026
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Functional Outcome and Donor Site Morbidity Following Posterior Cruciate Ligament (PCL) Reconstruction Using Peroneus
Hiranya Kumar1, Shuchindra R Chowdhary1, B A Pradeep2
1Orthopaedics and Trauma, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND.
Insights
The peroneus longus tendon (PLT) is a viable graft for posterior cruciate ligament (PCL) reconstruction, offering significant functional knee improvement. This study shows minimal donor site morbidity, supporting PLT as an alternative autograft option.
Area of Science:
- Orthopaedic Surgery
- Sports Medicine
- Biomaterials Science
Background:
- Posterior cruciate ligament (PCL) injuries pose significant challenges in orthopaedic management.
- The peroneus longus tendon (PLT) is being explored as a potential autograft source for PCL reconstruction.
- The efficacy and safety of PLT autografts in PCL reconstruction are not well-established.
Purpose of the Study:
- To evaluate the functional outcomes and donor site morbidity following arthroscopic single-bundle PCL reconstruction using ipsilateral PLT autograft.
- To assess the clinical efficacy of PLT autograft in patients with isolated PCL injuries.
Main Methods:
- A prospective observational study involving 25 patients (aged 18-50) with isolated PCL injuries.
- Arthroscopic single-bundle PCL reconstruction utilizing ipsilateral PLT autograft.
- Functional outcomes assessed via Tegner Lysholm Knee Score; donor site morbidity evaluated using Foot and Ankle Disability Index (FADI) and American Orthopedic Foot and Ankle Society (AOFAS) scores at 1, 3, and 6 months postoperatively.
Main Results:
- Significant improvement in mean Lysholm score from 48.60 preoperatively to 83.84 at 6 months (p < 0.001).
- FADI and AOFAS scores demonstrated an initial decrease followed by near-complete recovery at 6 months (p < 0.001).
- A complication rate of 16% was observed.
Conclusions:
- PLT autograft is a safe and effective graft option for PCL reconstruction, yielding significant functional knee improvements.
- The use of PLT autograft in PCL reconstruction is associated with minimal donor site morbidity.
- PLT autograft represents a viable alternative graft choice for posterior cruciate ligament reconstruction.
Abstract:
Background Posterior cruciate ligament (PCL) injuries present significant challenges in orthopaedic management. The peroneus longus tendon (PLT) has emerged as a potential autograft source; however, its role in PCL reconstruction remains underexplored. Methods A prospective observational study was conducted on 25 patients aged 18-50 years with isolated PCL injuries who underwent arthroscopic single-bundle reconstruction using ipsilateral PLT autograft. Functional outcomes were assessed using the Tegner Lysholm Knee Score, while donor site morbidity was evaluated using the Foot and Ankle Disability Index (FADI) and the American Orthopedic Foot and Ankle Society (AOFAS) score at one, three, and six months postoperatively. Results The mean Lysholm score improved significantly from 48.60 ± 7.77 preoperatively to 83.84 ± 8.13 at six months (p < 0.001). FADI and AOFAS scores showed an initial postoperative decline followed by near-complete recovery at six months (p < 0.001). Complications occurred in 16% of patients. Conclusion PLT autograft provides significant functional improvement with minimal donor site morbidity, supporting its use as a viable alternative graft option in PCL reconstruction.