Result of Anterior Cruciate Ligament Reconstruction by the Peroneus Longus Tendon

Open Access

Abstract

Background: ACL injuries are common in young active individuals and often impair knee stability and sports performance. While hamstring and patellar tendon autografts are widely used, the peroneus longus tendon (PLT) has gained attention as a suitable alternative due to its adequate graft properties and low donor-site morbidity. Aim of the study: To evaluate functional outcomes, knee stability, donor-site morbidity, and return-to-sports rates after ACL reconstruction using PLT autograft. Methods: A prospective observational study was conducted at Satkhira Medical College from January 2023 to December 2024. Thirty-two patients (18–45 years) with isolated ACL tears underwent reconstruction using the ipsilateral PLT. Functional outcomes (IKDC, Lysholm, Tegner, VAS) and AOFAS scores were recorded preoperatively and at final follow-up. Knee stability was assessed using Lachman, pivot shift, and KT-1000 tests. Donor-site morbidity, complications, and return-to-sports status were also documented. Data were analyzed with paired t-tests and chi-square tests (p<0.05). Results: The mean age was 28.5 years; 71.9% were male. Significant postoperative improvements were observed in IKDC, Lysholm, Tegner, and VAS scores (all p<0.001). KT-1000 difference improved from 6.1 mm to 1.7 mm, and normal Lachman and pivot shift tests were restored in 78.1% and 87.5% of patients, respectively. Donor-site morbidity was minimal, with only 6.3% showing mild eversion weakness. Overall, 75% returned to pre-injury sports within 9–12 months. Conclusion: PLT autograft provides strong functional improvement, reliable knee stability, minimal morbidity, and a high return-to-sports rate. It represents a safe, effective alternative graft option for primary ACL reconstruction.