Sohrab Keyhani - Bone, Joint and Related Tissues Research Center, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohammad Qoreishy - Bone, Joint and Related Tissues Research Center, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Maryam Mousavi - Faculty of Sciences, University of Guilan, Rasht, Iran
Hossein Ronaghi - Poursina Hospital Orthopaedic Research center, Guilan University of medical sciences, Rasht, Iran
Mehran Soleymanha - Poursina Hospital Orthopaedic Research center, Guilan University of medical sciences, Rasht, Iran

Background: Peroneus longus tendon can be a suitable alternative autograft for anterior cruciate ligament reconstruction (ACLR). The present study aimed to compare the clinical outcome and donor site morbidity in ACLR using peroneus longus tendon autograft versus hamstring tendon autograft. Methods: In a comparative cross-sectional study, ACLR was performed with quadrupled hamstring tendon autograft in ۶۵ patients between ۲۰۱۷ and ۲۰۱۸, and in another group, peroneus longus tendon autograft was used for ACLR in ۶۵ patients between ۲۰۱۸ and ۲۰۱۹. The same surgical technique, fixation method, and postoperative protocol were used in both groups. The knee functional outcomes were assessed according to the Lysholm score and the International Knee Documentation Committee scale at preoperative and at the end of at least ۲ years after the procedure. Moreover, graft diameter was measured intraoperatively. Thigh circumference, the American Orthopedic Foot and Ankle Score (AOFAS), The Foot & Ankle Disability Index (FADI), and ankle range of motion (ROM) were used to evaluate ankle donor site morbidities.Results: A total of ۱۳۰ patients (۶۵ patients in each group) were evaluated with a minimum follow-up of ۲ years (range ۲۴–۳۱ months). Both groups showed no significant differences in clinical outcomes and knee stability. The peroneus longus graft diameter was significantly larger than the hamstring diameter (P<۰.۰۰۱). Assessment of AOFAS, FADI, and ankle ROM showed no apparent ankle joint dysfunction in the peroneus longus tendon group.Conclusion: Faster knee extensions, less anteromedial knee pain, and thigh hypotrophy were observed in peroneus longus tendon patients. Peroneus longus tendon autograft can be an appropriate autograft for ACLR due to its strength, larger graft diameter, and avoiding potential complications of hamstring autograft obtained from the knee region.Level of evidence: IV

Anterior cruciate ligament reconstruction, Hamstring Tendon Autograft, peroneus longus tendon autograft