2023 ISAKOS Biennial Congress ePoster
Outcomes of Anterior Cruciate Reconstruction With Full-Thickness Peroneus Longus Tendon Autograft
Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), Bathinda, Punjab INDIA
Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, Kolkata, West Bengal INDIA
All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, INDIA
FDA Status Not Applicable
Summary
Peroneus longus autograft can be considered as a potential autograft option for ACL reconstruction in multi-ligament knee injuries and revision ACL reconstruction without significant donor site morbidity.
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Abstract
Background
Peroneus longus tendon autograft has been successfully used for isolated anterior cruciate ligament (ACL) reconstruction. Being a powerful evertor and flexor of great toe, there are concerns about associated ankle morbidity with this autograft option. However, there are only a few studies exploring ankle morbidity following harvest of peroneus longus tendon. This study aims to assess the functional outcomes, donor site morbidity and ankle strength after harvesting ipsilateral peroneus longus autograft for ACL reconstruction in revision ACL and multiligament injury cases.
Patients and methods: This was a prospective case series. All of the patients were evaluated by clinical examination for knee laxity, ankle joint stability, visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) score and Lysholm score, preoperatively and at two-year follow-up. Donor ankle was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and measurement of bilateral evertor and first ray plantar-flexion strength at two-year follow-up.
Results
Ipsilateral PLT graft was used in ten patients of revision ACL reconstruction, and 27 patients of the multi-ligament ligament knee injury. The mean length of harvested PLT was 26.2cm (standard deviation 2.6, range 22-31), and mean diameter of the doubled graft was 7.9mm (standard deviation 0.68, range 7.5-8.5). There was significant improvement in VAS score for pain, Lysholm and IKDC scores (p=<0.001) at two -year follow-up. There were no cases of graft failure, superficial or deep infection. Ankle dorsiflexion(p=0.32), ankle plantarflexion (p=0.19), eversion strength(p=0.6), first ray plantarflexion strength(p=0.52), and AOFAS score(p=0.29) were found to be comparable to the other side.
Conclusions
Peroneus longus autograft can be considered as a potential autograft option for ACL reconstruction in multi-ligament knee injuries and revision ACL reconstruction. No significant donor site morbidity was noted at follow-up.