Peroneus longus versus hamstring tendon autografts in arthroscopic anterior cruciate ligament reconstruction: A randomised controlled study.

BACKGROUND

Hamstring tendon autograft is widely used for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding graft size, harvest duration, and donor-site morbidity. Peroneus longus tendon (PLT) autograft has emerged as a potential alternative. This study compared PLT and hamstring tendon (HT) autografts in arthroscopic ACL reconstruction.

METHODS

A randomised controlled study was conducted at a tertiary orthopaedic centre. Adults with ACL rupture were allocated to HT (n = 81) or PLT (n = 81) autograft. Primary outcomes included graft harvest time and graft dimensions. Secondary outcomes included the Lysholm knee score, the American Orthopaedic Foot and Ankle Society (AOFAS) score, thigh circumference, and donor-site morbidity. Follow-up was performed at 1, 6, and 12 months.

RESULTS

PLT harvest was significantly faster than HT (7.13 ± 2.30 vs 24.37 ± 4.85 min; p < 0.05). PLT grafts were significantly longer and thicker (p < 0.05). Both groups demonstrated substantial improvement in Lysholm scores, with no significant difference at 12 months (p = 0.53). AOFAS scores in the PLT group returned to near-baseline by 6 months. The HT group exhibited significant thigh hypotrophy and one surgical site infection.

CONCLUSION

PLT autograft provided faster harvest, larger graft dimensions, and lower donor-site morbidity while achieving comparable early functional outcomes to HT autograft. PLT represents a reliable alternative graft option for arthroscopic ACL reconstruction.