Peroneus Longus Autograft versus Hamstring Autograft in Anterior Cruciate Ligament Reconstruction: One-year Follow-up Comparative Study

Abstract Background: Most injuries to the knee ligaments that occur in sports and accidents involve the anterior cruciate ligament (ACL). ACL reconstruction (ACLR) aids in restoring knee function and stability. The main autograft options available are the hamstring tendon (HT) and the bone-patellar tendon-bone (BPTB). Objectives: To compare the function and outcomes of the knee and ankle following ACLR using peroneus longus tendon (PLT) and hamstring tendon (HT) autografts. Patients and methods: Patients who underwent isolated single-bundle ACL reconstruction were divided into two groups. (hamstring tendon and peroneus longus tendon groups) and observed for one year. The functional scores of the knee (IKDC, Lysholm and modified Cincinnati) were assessed preoperatively and 1 year after surgery, as was thegraft diameter intraoperatively. Ankle morbidity was assessed using the AOFAS, FADI and VAS-FA scores in the peroneus longus group, in addition to thigh circumference measurements in both groups. Results: One hundred thirty patients fulfilled the inclusion criteria and were assigned to two groups (peroneus longus, n=65; hamstring, n=65). No significant differences in functional scores were observed between the groups. A significantly larger graft was observed in the peroneus longus group. The peroneus longus group showed excellent donor ankle function based on functional scores. Conclusion: PLT full-thickness autografts provide a stable painless knee, with an excellent range of motion and improved quality of life, comparable to those of hamstring tendon autografts at the one-year follow-up, with less thigh hypotrophy and excellent ankle function.