Peroneus Longus Tendon Autograft for Primary Arthroscopic Reconstruction of the Anterior Cruciate Ligament

Purpose. Peroneus longus tendon graft is not a popular first choice for ACL reconstruction. However, newer literature has shown good outcomes with its use. This study compares functional outcome and donor site morbidity of peroneus longus with hamstring tendon autograft to assess if it can be considered as one of the first choices for ACLR. Methods. This prospective cohort study involves 54 patients who underwent arthroscopic single-bundle ACLR. 27 patients each were operated on with hamstring and peroneus longus autografts. At 2 years follow-up, functional outcome was compared between groups using International Knee Documentation Committee (IKDC), Modified Cincinnati, and Tegner-Lysholm scores. Donor site morbidity in the peroneus longus group was assessed using Foot and Ankle Disability Index (FADI) and The American Orthopaedic Foot and Ankle Society (AOFAS) scores. Results. At 2 years follow-up, there was no statistically significant difference in the mean IKDC (77.26 vs 80.78), Modified Cincinnati (84.41 vs 89.07), and Tegner-Ly-sholm scores (85.19 vs 88.78) between the hamstring and peroneus groups respectively. Mean FADI and AOFAS scores at 2 years follow up were 96.11 and 91.67 respectively in the peroneus group suggesting no significant donor site morbidity as compared to preoperative scores. Conclusions. Peroneus longus performs similar to hamstring grafts and can be considered as one of the first choices for arthroscopic ACL reconstruction.