Functional knee and ankle outcomes of a peroneus longus tendon autograft for primary reconstruction of the anterior cruciate ligament

Background
Peroneus longus tendon (PLT) autograft is commonly used for anterior cruciate ligament (ACL) reconstruction because it is easily harvested and has the same size and strength as the ACL. There are few studies in the literature that discussed donor site complications after ACL reconstruction by PLT. PLT was used as an autograft for reconstructions of the medial patellofemoral ligament and deltoid ligament. We evaluated clinical and functional outcomes for knee, foot, and ankle joints after the use of PLT as an autograft in primary isolated ACL reconstruction.
Patients and methods
We retrospectively reviewed all patients who were operated for primary ACL reconstruction by PLT autograft from May 2020 to May 2021. Preoperatively and postoperatively, all patients were examined clinically for knee stability by anterior drawer, Lachman, and pivot shift tests, applying the International Knee Documentation Committee as well as the Lysholm score. American Orthopedic Foot and Ankle Score, Foot and Ankle Ability Measure, and ankle range of motion were used for the evaluation of postoperative foot and ankle functions. Return time to the sport was also evaluated.
Results
Sixty-five patients with ACL-injured knees were included. Their mean age was 29.81 ± 8.33 years and ranged from 20 to 45 years, and males were 54 (83%) and females were 11 (17%). The mean postoperative follow-up period was 32.5 ± 3.1 months. Mean of American Orthopedic Foot and Ankle Score was 99.33 and Foot and Ankle Ability Measure was 99.7 after 12 months. Postoperative Lysholm score mean±SD was 95.30 ± 4.65, and the International Knee Documentation Committee mean±SD was 93.47 ± 9.82 with P value less than 0.001. Return to sport ranged from 4 to 8 months with mean±SD of 5.67 ± 0.75.
Conclusion
PLT autograft for primary reconstruction of isolated ACL injury did not affect foot and ankle functions with good knee stability and restoration of knee functions postoperatively, which facilitated the return to preoperative sports activity level.