Publication:

Functional outcomes in arthroscopic anterior cruciate ligament reconstruction using peroneus longus tendon graft

Background Anterior cruciate ligament (ACL) rupture is a common knee injury in active individuals, leading to instability, meniscal and chondral damage, and early osteoarthritis. Arthroscopic ACL reconstruction is the preferred treatment. The concerns about donor site morbidity have prompted interest in alternative grafts such as the peroneus longus tendon, which offers adequate strength and potentially lower morbidity. This study evaluates the functional outcomes of arthroscopic ACL reconstruction using peroneus longus tendon autograft.

Methods This 30-month prospective study at a tertiary centre evaluated arthroscopic ACL reconstruction with ipsilateral peroneus longus autograft in ≥34 skeletally mature patients (≥18 years) with complete ACL rupture and instability. Single-bundle medial portal technique used Endo button and interference screw fixation. Outcomes assessed preoperatively and at 3, 6, and 9 months using Tegner-Lysholm (T-L), International Knee Documentation Committee (IKDC) knee, and AOFAS ankle scores.

Results The mean age of patients was 30.41 years±5.83, with male predominance (61.76%). Sports injury was the most common cause (55.88%), 73.53% had a graft diameter of 9 mm. The mean T-L score improved significantly from 65.79±4.66 preoperatively to 90.85±2.10 at 9 months. The mean IKDC score increased from 59.91±7.23 to 92.02±2.34. The mean AOFAS score decreased from 100±0.00 to 98.29±1.91, remaining within excellent to good range.

Conclusions Peroneus longus autograft ACL reconstruction delivers excellent functional recovery and minimal donor-site impact, ideal for active patients.