Andre Giardino Moreira da Silva , Rodrigo Sousa Macedo , Gil Goulart Choi , Pedro Nogueira Giglio , Riccardo Gomes Gobbi , Alexandre Leme Godoy-Santos , Camilo Partezani Helito
{"title":"腓骨长肌腱的踝下摘取:外科技术。","authors":"Andre Giardino Moreira da Silva , Rodrigo Sousa Macedo , Gil Goulart Choi , Pedro Nogueira Giglio , Riccardo Gomes Gobbi , Alexandre Leme Godoy-Santos , Camilo Partezani Helito","doi":"10.1016/j.jisako.2025.100384","DOIUrl":null,"url":null,"abstract":"<div><div>Peroneus longus tendon (PLT) graft has recently gained visibility in the literature as a promising option for knee ligament reconstructions. The most used harvesting technique is performed with a single incision posterior to the lateral malleolus, with large series reporting tendon lengths enough to prepare a double or triple anterior cruciate ligament (ACL) graft, resulting in mean diameters greater than 8.0 mm. However, as happens with the hamstrings, some patients may present PLT grafts with a 7-mm diameter, which is associated with higher failure rates and is the minimum acceptable diameter for ACL reconstructions. In turn, the 2-incision technique has longer graft lengths reported, enough to prepare 4-folded grafts, with mean diameters above 9.0 mm, ranging from 8.5 to 10 mm. Once the PLT graft diameter has a direct correlation with anthropometric measurements, as well as larger ACL graft diameters are associated with lower failure rates and revision surgeries, the inframalleolar harvesting seems to be a reasonable option, especially for short-stature patients with a greater risk of insufficient grafts. Additionally, patients who benefit from an extra-articular procedure can have a combined reconstruction of the ACL and anterolateral ligament using the PLT graft with the two-incision technique, with no need for another graft. Therefore, this article aims to describe the step-by-step technique for the inframalleolar PLT harvesting.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100384"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Inframalleolar harvest of the peroneus longus tendon graft: Surgical technique\",\"authors\":\"Andre Giardino Moreira da Silva , Rodrigo Sousa Macedo , Gil Goulart Choi , Pedro Nogueira Giglio , Riccardo Gomes Gobbi , Alexandre Leme Godoy-Santos , Camilo Partezani Helito\",\"doi\":\"10.1016/j.jisako.2025.100384\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Peroneus longus tendon (PLT) graft has recently gained visibility in the literature as a promising option for knee ligament reconstructions. The most used harvesting technique is performed with a single incision posterior to the lateral malleolus, with large series reporting tendon lengths enough to prepare a double or triple anterior cruciate ligament (ACL) graft, resulting in mean diameters greater than 8.0 mm. However, as happens with the hamstrings, some patients may present PLT grafts with a 7-mm diameter, which is associated with higher failure rates and is the minimum acceptable diameter for ACL reconstructions. In turn, the 2-incision technique has longer graft lengths reported, enough to prepare 4-folded grafts, with mean diameters above 9.0 mm, ranging from 8.5 to 10 mm. Once the PLT graft diameter has a direct correlation with anthropometric measurements, as well as larger ACL graft diameters are associated with lower failure rates and revision surgeries, the inframalleolar harvesting seems to be a reasonable option, especially for short-stature patients with a greater risk of insufficient grafts. Additionally, patients who benefit from an extra-articular procedure can have a combined reconstruction of the ACL and anterolateral ligament using the PLT graft with the two-incision technique, with no need for another graft. Therefore, this article aims to describe the step-by-step technique for the inframalleolar PLT harvesting.</div></div>\",\"PeriodicalId\":36847,\"journal\":{\"name\":\"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine\",\"volume\":\"11 \",\"pages\":\"Article 100384\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S205977542500001X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S205977542500001X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Inframalleolar harvest of the peroneus longus tendon graft: Surgical technique
Peroneus longus tendon (PLT) graft has recently gained visibility in the literature as a promising option for knee ligament reconstructions. The most used harvesting technique is performed with a single incision posterior to the lateral malleolus, with large series reporting tendon lengths enough to prepare a double or triple anterior cruciate ligament (ACL) graft, resulting in mean diameters greater than 8.0 mm. However, as happens with the hamstrings, some patients may present PLT grafts with a 7-mm diameter, which is associated with higher failure rates and is the minimum acceptable diameter for ACL reconstructions. In turn, the 2-incision technique has longer graft lengths reported, enough to prepare 4-folded grafts, with mean diameters above 9.0 mm, ranging from 8.5 to 10 mm. Once the PLT graft diameter has a direct correlation with anthropometric measurements, as well as larger ACL graft diameters are associated with lower failure rates and revision surgeries, the inframalleolar harvesting seems to be a reasonable option, especially for short-stature patients with a greater risk of insufficient grafts. Additionally, patients who benefit from an extra-articular procedure can have a combined reconstruction of the ACL and anterolateral ligament using the PLT graft with the two-incision technique, with no need for another graft. Therefore, this article aims to describe the step-by-step technique for the inframalleolar PLT harvesting.