Functional Outcomes of Anatomic Single Bundle Primary ACL Reconstruction with Peroneus Longus Tendon (Without a Peroneal Tenodesis) Versus Hamstring Autografts

Objectives: There is a paucity of comparative studies on the Peroneus longus tendon versus conventional hamstring autograft use in primary single-bundle ACL reconstruction. To date, there are no studies that reported donor ankle functional outcomes when a peroneus lon gus graft is harvested without performing a tenodesis to peroneus brevis.Methods: A single-center retrospective comparative study was undertaken to evaluate the functional outcomes (IKDC & Tegner-Lysholm scores) of primary isolated single bundle anatomic ACL Reconstruction with Peroneus Longus tendon (PL group) versus Hamstring (HT group) autografts. Further, an evaluation of donor ankle morbidity using the AOFAS score for the PL group and persistent anteromedial thigh pain and paraesthesia around the kneefor the HT group was also performed.Results: ۳۰ patients were evaluated in each group. The mean graft diameter was ۸.۶۱ +/- ۰.۶۶mm (HT) & ۹.۶ +/-۰.۸۴mm (PL) and the mean graft length was ۷.۳۹cm (HT) & ۷.۸۶cm (PL) respectively. The mean IKDC scores were ۵۸.۲ (Pre-op) & ۸۹.۵۲ (۱ year) for the HT group and ۶۱.۸ (Pre-op) & ۹۰.۹ (۱ year) for the PL group respectively. The mean Tegner-Lysholm scores were ۶۹.۸۳ (Pre-op) & ۹۱.۹۶ (۱ year) for the HT group and ۷۰.۶۶ (Pre-op) & ۹۲.۳۶ (۱ year) for the PL group respectively.۱۰% of the HT group had residual anteromedial thigh pain & ۶.۷% had paraesthesia at one-year follow-up. In the PL group, the mean AOFAS score was ۹۶.۳۷ +/- ۲.۴۹ at the end of one year. Two cases (۶.۶۶%) reported paraesthesia around the harvested site.Conclusion: Peroneus longus tendon appears to be a better autograft choice than hamstrings for primary ACL reconstruction. Further, without a peroneal tenodesis, the functional outcomes of the donor ankle remained excellent. Level of evidence: III

Keywords:

ACL reconstruction , Ankle , Hamstring , peroneus longus tendon , tenodesis