Evaluation of knee stability and functional outcome following ACL reconstruction with peroneus longus tendon autograft

Open Access

Abstract

Background: Anterior cruciate ligament (ACL) injury is a common cause of knee instability leading to functional impairment. ACL reconstruction using peroneus longus tendon autograft has emerged as a promising option with satisfactory clinical outcomes. This study aimed to evaluate knee stability and functional outcome following ACL reconstruction using peroneus longus tendon autograft. Methods & Materials: This prospective observational study was conducted in the Department of Orthopaedics & Traumatology at Khwaja Yunus Ali Medical College & Hospital from December 2023 to May 2026 over 2.5 years. A total of 40 patients with ACL injury who underwent reconstruction using peroneus longus tendon autograft were included. Knee stability was assessed using Lachman, anterior drawer and pivot shift tests, while functional outcome was evaluated using the Lysholm Knee Scoring Scale. Data were analyzed using SPSS version 25. Results: The mean age of patients was 31.8 ± 8.6 years, with a male predominance (77.5%). Sports injury was the most common cause (40%). Postoperatively, significant improvement in knee stability was observed, with Lachman test positivity reduced from 97.5% to 10%, anterior drawer test from 92.5% to 12.5% and pivot shift test from 85% to 15%. Functional outcome improved markedly, with mean Lysholm score increasing from 58.6 ± 9.4 preoperatively to 91.3 ± 6.8 postoperatively. At six months, 82.5% of patients achieved good to excellent outcomes. Conclusion: ACL reconstruction using peroneus longus tendon autograft provides excellent improvement in knee stability and functional outcomes and may be a reliable graft option for ACL-deficient patients.