Summary

Distally suturing the PLT to PBT during harvesting the tendon had comparable outcomes compared to not distally suture it.

Abstract

Introduction

An ideal autograft donor for anterior cruciate ligament reconstruction (ACLR) should have an acceptable amount of strength, be an adequate size, and be easily harvested without causing too much donor site morbidity. There is increasing popularity of using peroneus longus tendon (PLT) autograft in recent years. There is still controversy whether to perform distal stump suturing into the peroneus brevis tendon (PBT) tendon in term of donor-site morbidity of the ankle.

Materials And Methods

We performed a randomized controlled trial study in patients underwent ACLR using PLT autograft. The subjects were divided into group of distal stump suturing to PBT and group without distal suturing. The surgeries were performed in academic teaching hospitals in December 2018 - June 2021. We measured the subjective functional outcomes of visual analog scale – Foot and Ankle (VAS-FA) and American Orthopaedic Foot and Ankle Society (AOFAS) preoperatively, immediately preoperative, and 3-months and 6-months postoperative. The objective measurements were the motoric strength and measurement of Clarke’s angle.

Results

A total of 24 patients were included in the study, 12 patients in each group. The motor strength in 3-months and 6-months postoperative in distal suturing group was higher than without distal suturing group, however the difference was not statistically significant (p=0.426 and p=0.429, respectively). There was no significant difference between the Clarke’s angle in 3-months and 6-months postoperative in both distal suturing and without distal suturing groups (p=0.613 and p=0.757, respectively). There was no significant difference between the AOFAS score in 3-months and 6-months postoperative in both distal suturing and without distal suturing groups (p=0.530 and p=0.934, respectively). Also, there was no significant difference between the AOFAS score in 3-months and 6-months postoperative in both distal suturing and without distal suturing groups (p=0.414 and p=0.126, respectively).

Conclusion

In harvesting the PLT tendon as autograft for ACLR, distal stump suturing had a comparable donor site morbidity compared to not distally suture the stump. This study concluded that distally suturing the PLT to PBT during harvesting the tendon had comparable outcomes compared to not distally suture it.