Related Experiment Video
Updated: Sep 7, 2026
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Reconstruction of a 2‑year neglected chronic patellar tendon rupture using peroneus longus autograft with suture
Mao-Yi Yang1, Li-Wei Hung1,2
1Department of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Rationale:
Chronic patellar tendon rupture with complete tendon loss is difficult to reconstruct when primary repair is impossible. We report reconstruction using an ipsilateral peroneus longus (PL) autograft in a 4-strand "M-shaped" configuration with suture-anchor fixation and temporary cerclage augmentation.
Patient Concerns:
A 17-year-old male had progressive anterior knee pain, instability, and inability to actively extend the left knee for 2 years after trauma.
Diagnoses:
Examination showed patella alta, a palpable infrapatellar gap, and complete loss of active extension. Radiographs showed an Insall-Salvati ratio of 1.28. Magnetic resonance imaging confirmed chronic complete patellar tendon rupture without a repairable stump.
Interventions:
A 21-cm ipsilateral PL autograft was folded into a 4-strand construct and anchored to the inferior patella and tibial tubercle. Patellar height was deliberately overcorrected, and a transpatellar-tibial cerclage wire protected the reconstruction during staged rehabilitation.
Outcomes:
At 1 year, after wire removal, the Insall-Salvati ratio was 1.08. The patient regained full active extension without lag, near-full flexion, and recreational activity participation without pain or donor-site morbidity. Asymptomatic wire breakage occurred at 6 months.
Lessons:
A multi-strand PL autograft with anchor fixation and temporary cerclage augmentation may restore patellar height and extensor function in chronic patellar tendon rupture with complete tendon loss.
