Citation Information :
Khalid KM, Vajrangi A, Reddy E, Sherikar N, Yellappa RC, Kurupati RB. Hamstring vs Peroneus Longus Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A Comparative Study. 2024; 6 (2):109-113.
Introduction: Anterior cruciate ligament (ACL) injury is one of the most common knee ligament injuries. There is much debate about the best treatment for this injury, and many studies have been conducted to compare different graft options. Hamstring (HT) autografts have withstood the test of time and are currently the most commonly used graft for ACL reconstruction (ACLR). However, there are also many alternative graft options that have been explored and are being used. In this article, we will explore whether the peroneus longus (PL) graft can be a comparable alternative to the HT graft.
Materials and methods: We conducted a prospective randomized study involving 80 patients who underwent ACLR. These patients were divided into two equal groups randomly—the HT group and the peroneus longus tendon (PLT) group. To evaluate functional outcomes, we utilized the International Knee Documentation Committee (IKDC) score for the knee joint, while the American Orthopaedics Foot and Ankle Scoring System (AOFAS) was employed for assessing the ankle joint. To gauge donor site morbidity, we measured thigh circumference preoperatively and postoperatively. These measurements were taken at 1- and 2-year follow-up intervals.
Results: A total of 80 patients were evaluated with a minimum follow-up of 2 years. In terms of clinical outcomes and knee stability, neither group displayed any discernible differences. The diameter of the PL graft was substantially bigger than the diameter of the HT. The PLT group did not appear to have any abnormal ankle joint function according to the assessment of AOFAS and ankle range of motion (ROM). The HT group showed a significant wasting of the quadriceps when compared to the PLT group.
Conclusion: With regard to its strength, larger graft diameter, satisfactory ankle function, and prevention of potential complications of HT autograft obtained from the knee region, the current study demonstrated that PLT autograft might be considered a safe and practical autograft source for arthroscopic ACLR.
Keyhani S, Qoreishi M, Mousavi M, et al. Peroneus longus tendon autograft versus hamstring tendon autograft in anterior cruciate ligament reconstruction: a comparative study with a mean follow-up of two years. Arch Bone Jt Surg 2022;10(8):695–701. DOI: 10.22038/ABJS.2022.59568.2938
Daniel DM, Stone ML, Dobson BE, et al. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med 1994;22(5):632–644. DOI: 10.1177/036354659402200511
Cristiani R, Forssblad M, Engström B, et al. Risk Factors for abnormal anteroposterior knee laxity after primary anterior cruciate ligament reconstruction. Arthroscopy 2018;34(8):2478–2484. DOI: 10.1016/j.arthro.2018.03.038
Kumar PM, Shevte I, Phalak M, et al. Arthroscopic anterior cruciate ligament reconstruction with semitendinosus graft versus peroneus longus tendon graft. Int J Res Orthop 2020;6(2):386–392. DOI: 10.18203/issn.2455-4510.IntJResOrthop20200735
Yasuda K, Van Eck F, Hoshino Y, et al. Anatomic single- and double-bundle anterior cruciate ligament reconstruction, part 1: basic science. Am J Sports Med 2011;39(8):1789–1799. DOI: 10.1177/0363546511402659
Chen H, Tie K, Qi Y et al. Anteromedial versus transtibial technique in single-bundle autologous hamstring ACL reconstruction: a meta-analysis of prospective randomized controlled trials. J Orthop Surg Res 2017;12(1):167. DOI: 10.1186/s13018-017-0671-3
Wiradiputra AE, Febyan, Aryana GNW. Peroneus longus tendon graft for anterior cruciate ligament reconstruction: a case report and review of literature. Int J Surg Case Rep 2021;83:106028. DOI: 10.1016/j.ijscr.2021.106028
Goyal T, Paul S, Choudhury AK, et al. Full-thickness peroneus longus tendon autograft for anterior cruciate reconstruction in multi-ligament injury and revision cases: outcomes and donor site morbidity. Eur J Orthop Surg Traumatol 2023;33(1):21–27. DOI: 10.1007/s00590-021-03145-3
Agarwal A, Singh S, Singh A, et al. Comparison of functional outcomes of an anterior cruciate ligament (ACL) reconstruction using a peroneus longus graft as an alternative to the hamstring tendon graft. Cureus 2023;15(4):e37273. DOI: 10.7759/cureus.37273
He J, Tang Q, Ernst S, et al. Peroneus longus tendon autograft has functional outcomes comparable to hamstring tendon autograft for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021;29(9):2869–2879. DOI: 10.1007/s00167-020-06279-9
Hossain GMJ, Islam MS, Rahman Khan MM, et al. A prospective study of arthroscopic primary ACL reconstruction with ipsilateral peroneus longus tendon graft: experience of 439 cases. Medicine (Baltimore) 2023;102(9):e32943. DOI: 10.1097/MD.0000000000032943