Functional and clinical outcome of arthroscopic primary single bundle anterior cruciate ligament reconstruction using peroneus longus autograft

Abstract

Background: Peroneus longus tendon (PLT) autograft has emerged as one of the primary graft options for arthroscopic anterior cruciate ligament reconstruction (ACLR). We aimed to study whether PLT autograft could be used as primary graft for arthroscopic single bundle ACLR, without compromising stability of donor ankle. Materials and Methods: A prospective observational study of 120 patients, who underwent single bundle arthroscopic ACLR with ipsilateral PLT autograft was done. Functional outcome of patients were evaluated with international knee documentation (IKDC) and Lysholm knee scores after one year. The donor ankle morbidity was assessed using American orthopedic foot and ankle score (AOFAS) and foot and ankle disability index (FADI) scores. Results: The mean IKDC pre-op subjective score was 55.3 ± 10.7 and after one year follow-up was 91.4 ± 5.86. The mean difference of IKDC score between pre-op and post-op evaluation was 33.1 ± 11.4, with a p-value of <0.001. The pre-operative mean Lysholm score was 67.6 ± 10.8 and on follow-up after 1 year was 93.6 ± 6.3. The mean difference of Lysholm score was 25.1± 10.4, and p-value <0.001. The mean AOFAS score was 98.14 ± 3.16 and the mean FADI score was 98.37 ± 2.71 on one year follow-up. Conclusion: The significant improvements in IKDC and Lysholm knee scores after using PLT autograft, makes it one of the graft choices for ACLR. The apprehension of donor ankle instability is mitigated by excellent AOFAS and FADI scores reported in the study. PLT is an ideal graft choice for arthroscopic primary single bundle ACLR. Keywords: anterior cruciate ligament; peroneus longus tendon; autograft; arthroscopy; ACL reconstruction