Peroneus Longus Tendon Autograft versus Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction: a comparative study with a mean follow-up of 2 years

Document Type : RESEARCH PAPER


1 Bone, Joint and Related Tissues Research Center, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Faculty of Sciences, University of Guilan, Rasht, Iran

4 Poursina Hospital Orthopaedic Research center, Guilan University of medical sciences, Rasht, Iran

5 Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran


Background: Peroneus longus tendon can be considered as a suitable alternative autograft for anterior cruciate ligament reconstruction (ACLR). This 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 65 patients between 2017 and 2018, and in another group, peroneus longus tendon autograft was used for ACLR in 65 patients between 2018 and 2019. 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 (IKDC) scale at preoperative and the end of at least 2 years after the procedure. 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 were used to evaluate ankle donor site morbidities.
Results: 130 patients (65 patients in each group) were evaluated with a minimum follow-up of 2 years (range 24–31 months). There were no significant differences in clinical outcomes and knee stability in both groups. The peroneus longus graft diameter was significantly larger than the hamstring diameter (p < 0.001). Assessment of AOFAS, FADI and ankle range of motion showed no obvious ankle joint dysfunction in the peroneus longus tendon group.
Conclusions: 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 with respect to its strength, larger graft diameter and avoiding potential complications of hamstring autograft obtained from the knee region.


Articles in Press, Accepted Manuscript
Available Online from 15 February 2022
  • Receive Date: 11 August 2021
  • Revise Date: 23 October 2021
  • Accept Date: 02 February 2022
  • First Publish Date: 15 February 2022