Title: Comparative Study of Arthroscopic ACL Reconstruction with Peroneus Longus Autograft vs Hamstring Autograft

Authors: Dr Naef Iqbal, Dr A.K.Mahto

 DOI: https://dx.doi.org/10.18535/jmscr/v12i03.09

Abstract

Introduction

The ACL is 1 of 4 main ligaments in the knee. Ligaments are rope-like structures that connect and hold the bones together to keep the knee stable. 

There are two components of the ACL, the anteromedial bundle (AMB) and the posterolateral bundle (PLB). 

The ACL has a microstructure of collagen bundles of multiple types (mostly type I) and a matrix made of a network of proteins, glycoproteins, elastic systems, and glycosaminoglycans.

The ACL is innervated by posterior articular branches of the tibial nerve and is vascularized by branches of the middle genicular artery.

Anterior cruciate ligament (ACL) reconstruction improves knee stability and function.

Phatama et al. reported that there was no significant difference between the peroneus longus and hamstring tendon in terms of tensile strength.

Peroneus longus tendon autografts are commonly used in some orthopedic procedures, including spring ligament reconstruction, deltoid ligament reconstruction and medial patellofemoral ligament reconstruction.

This is possible, due to the synergistic function of the peroneus longus and peroneus brevis.

Some studies have even found that the peroneus brevis is a more effective evertor of the ankle, justifying the harvest of the peroneus longus tendon.

References

  1. Liu CT, Lu YC, Huang CH. Half-peroneus-longus-tendon graft augmentation for unqualified hamstring tendon graft of anterior cruciate ligament reconstruction. J Orthop Sci 2017; 20(5):854- 60.
  2. Shi FD, Hess DE, Zuo JZ, Liu SJ, Wang XG, Zhang Y, et al. Peroneus Longus Tendon Autograft is a Safe and Effective Alternative for Anterior Cruciate Ligament Reconstruction. J Knee Surg 2019; 32(8):804-811.
  3. Nazem K, Barzegar M, Hosseini A, Karimi M. Can we use peroneus longus in addition to hamstring tendons for anterior cruciate ligament reconstruction? Adv Biomed Res 2018; 3:15.
  4. Magnussen R, Lawrence J, West R, Toth A, Taylor D, Garrett W. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy 2016; 28(4)526-31.
  5. Marchand J, Ruiz N, Coupry A, Bowen M, Robert H. Do graft diameter or patient age influence the results of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc 2016; 24(9):2998-3004.
  6. Zhao J, Huangtu X. The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft source. Am J Sports Med 2020; 40(3):662-71.
  7. Rudy, Mustamsir E, Phatama KY. Tensile strength comparison between peroneus longus and hamstring tendons: A biomechanical study. International Journal of Surgery Open 2019; 9:41-44.

Corresponding Author

Dr Naef Iqbal

Resident, Department of Orthopedics (KMCH)