Single bundle ACL reconstruction with peroneus longus tendon graft: 2-years follow-up

Background: Peroneus longus tendon autograft resembles hamstring tendon's biomechanical strength. Thus, peroneus longus is a potential graft in reconstructive orthopaedic procedures. However, there was few study in evaluation of peroneus longus usage in ACL reconstruction. This study aimed to quantify the clinical outcome and donor site morbidity in ACL reconstruction using peroneus longus tendon autograft. Methods: Patients who suffered isolated ACL injury were enrolled and underwent isolated single bundle ACL reconstruction using peroneus longus autograft. Functional score (IKDC, Modified Cincinnati, and Tegner-Lysholm score) were assessed at pre-operative and 2-years after surgery. Graft diameter was measured intraoperative. Donor site morbidities were assessed with thigh circumference measurement and ankle scoring using AOFAS and FADI. We also measured serial hop test. Results: Seventy-five patients fulfilled inclusion criteria. Peroneus longus graft diameter was 8.38 ± 0.68 mm. There was significant difference between pre and 2-years post-operative functional score in IKDC, Modified Cincinnati, and Tegner-Lysholm score. Mean of AOFAS was 98.93 ± 3.10 and FADI was 99.79 ± 0.59 with no significant decrease of thigh circumference, and good serial hop test result. Conclusion: ACL reconstruction with peroneus longus autograft has excellent functional score in IKDC, Modified Cincinnati, Tegner-Lysholm score at 2-years follow up with the advantages of greater graft diameter, less thigh hypotrophy, good serial hop test result, and excellent ankle function based on AOFAS and FADI score. Level of evidence: Level 2, Prospective Cohort Study.