Assessment of Donor-Site Morbidity Using Shear Wave Elastography After Peroneus Longus Autograft Harvest for ACL...

Background/Objectives: The peroneus longus tendon has gained attention as an alternative autograft source for anterior cruciate ligament reconstruction; however, donor-site morbidity remains a concern because of its role in ankle eversion and lateral ankle function. Methods: This cross-sectional observational study evaluated whether peroneus longus tendon harvest causes measurable donor-site changes using shear wave elastography. Forty patients who underwent anterior cruciate ligament reconstruction with a peroneus longus tendon autograft and who completed at least 12 months of follow-up were included. The graft-harvested side was compared with the contralateral side in terms of ankle plantar flexion, eversion range of motion, and shear wave elastography-derived tendon stiffness. Results: Pain was assessed using the visual analog scale. Postoperative VAS scores were significantly lower than preoperative scores [8 (5-9) vs. 2 (1-4); p < 0.001]. No significant differences were found between the graft-harvested and contralateral sides in plantar flexion, eversion, or tendon stiffness. A strong positive correlation was observed between operated-side and contralateral-side shear wave elastography values (r = 0.950; p < 0.001). Conclusions: Peroneus longus tendon harvest was not associated with measurable residual tendon stiffness or ankle range-of-motion changes at 12 months.