Chronic Patellar Tendon Reconstruction Using Ipsilateral Peroneus Longus Autograft

Chronic patellar tendon rupture is a rare and challenging injury that compromises knee extension and overall function. Conventional repair often requires augmentation or reconstruction using autografts, allografts, or synthetic materials, with most techniques involving transpatellar tunnels, which increase the risk of iatrogenic fracture. This technical note describes an approach for chronic patellar tendon repair using an ipsilateral peroneus longus autograft in a figure-of-eight configuration, avoiding transpatellar tunnels. Fixation is achieved with suture anchors at the tibial tuberosity and a single transverse tibial tunnel. This method provides robust biomechanical stability, minimizes complications, and leverages the advantages of the peroneus longus graft, including consistent size and low donor-site morbidity.