Comparative Study of Peroneus Longus Tendon Versus Hamstring Tendon Graft in Arthroscopic Reconstruction of Anterior Cruciate Ligament

Abstract

Background: Anterior cruciate ligament (ACL) injuries are among the most common sports-related knee injuries. Various autografts are used for ACL reconstruction, with semitendinosus (hamstring) tendon being widely preferred. However, the peroneus longus tendon (PLT) has recently emerged as a promising alternative due to its favorable biomechanical properties and minimal donor site morbidity.

Objectives: To compare the functional outcomes of ACL reconstruction using peroneus longus tendon versus hamstring tendon autografts.

Materials and Methods: This prospective clinical study was conducted at B.L.D.E. (Deemed to be University), Shri B.M. Patil Medical College, Vijayapura, Karnataka, from January 2023 to January 2025. A total of 24 patients with ACL rupture were equally divided into two groups: Group 1 (n=12) received semitendinosus grafts, and Group 2 (n=12) received peroneus longus grafts. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) subjective score and the Lysholm knee scoring scale preoperatively and at 6 months postoperatively.

Results: Both groups showed significant improvement in IKDC and Lysholm scores postoperatively. At 6 months, mean Lysholm scores were 97.00 ± 4.16 (Group 1) and 98.50 ± 2.36 (Group 2), and mean IKDC scores were 94.38 ± 3.37 (Group 1) and 95.66 ± 2.49 (Group 2). No significant complications, including ankle instability, were reported in the PLT group.

Conclusion: ACL reconstruction using peroneus longus tendon autograft provides comparable functional outcomes to hamstring tendon grafts, with minimal donor site morbidity. PLT is a viable alternative, particularly when hamstring grafts are inadequate or unavailable.