Functional Outcomes and Hop Tests Results in ACL Reconstruction Patients with Adjustable Loop Fixation: 2 Years Follow-up

Background: Arthroscopic Anterior Cruciate Ligament (ACL) reconstruction is one of the most performed knee surgery, which results in early return to sport and good clinical outcomes. The outcomes are affected by various factors, namely type of grafts, graft fixation methods, tunnel orientations and diameters. If good operative results and intensive pre- and post-operative rehabilitation lead to an optimal outcome, patients can return to the pre-injury level of sports activity in the short term. Objective: Muscle strength and stability of anterior cruciate ligament in reconstructed knees have been bilaterally compared with The Peroneus Longus Tendon grafts at preoperative, 6 month and 2 years following surgery. Methods: Forty-seven patients, 40 men, and 7 women, participated in the study. The outcome measures using IKDC, Cincinnati and Tegner-Lysholm score. Hop tests were evaluated on 6th month after the surgery. Results: Results of preoperative and 2-years postoperative functional outcomes are shown the IKDC score, Tegner-Lysholm score, and Cincinnati score yielded statistically significant differences (p<0.001) between their pre- and postoperative score from 56,3% until 98,0%. The median of the hop tests were 92, 94, 94, and 95, for the single, triple, cross over, and timed tests, respectively Conclusion: In this retrospective study of 47 patients undergoing ACL reconstruction with adjustable loop fixation (GraftMax™ Button, CONMED) on the femoral site and peroneus longus tendon autograft, we found that in 2 years of follow up, the functional outcomes and hop tests were favorable. Good surgery technique and intensive pre- and post-surgery rehabilitation are very important. Six months after surgery patients are allowed to go back to sports activity.

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Functional Outcomes and Hop Tests Results in Anterior Cruciate Ligament Reconstruction Patients with Adjustable Loop Fixation: 2-Years Follow-up

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5260 ◽

2020 ◽

Vol 8 (A) ◽

pp. 892-897

Author(s):

Sholahuddin Rhatomy ◽

Chairul Wahjudi ◽

Thomas Edison Prasetyo ◽

Riky Setyawan ◽

Nicolaas C. Budhiparama

Keyword(s):

Anterior Cruciate Ligament ◽

Functional Outcome ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Lysholm Score ◽

Functional Score ◽

Peroneus Longus ◽

Hop Test ◽

Anterior Cruciate

BACKGROUND: Grafts are ultimately integrated into the bone tunnels by either screws, cross-pins, or cortical suspension devices in anterior cruciate ligament (ACL) reconstruction. Investigation the usage of adjustable loop button is inadequate. AIM: The aim of this study was to identify knee functional outcome and serial hop test in ACL reconstruction with adjustable loop button in 2-years follow-up. METHODS: Chronic isolated ACL ruptured patients were reconstructed with adjustable loop button using peroneus longus autograft. We recorded knee functional outcome score using Tegner-Lysholm score, Modified Cincinnati score, and International Knee Documentation Committee (IKDC) at pre-operative and 2-years follow-up. Serial hop test was assessed at 6 months after surgery. RESULTS: Forty-seven patients fulfilled inclusion criteria with median age 22.0. Evaluation of functional outcome of Tegner-Lysholm score, Modified Cincinnati score, and IKDC showed significant improvement at 2-years follow-up compared to pre-operative. Serial hop test showed excellent result at 6 months after surgery. CONCLUSION: The result of knee functional score (Tegner-Lysholm score, Modified Cincinnati score, and IKDC) and serial hop test in ACL reconstruction with adjustable loop using peroneus longus autograft was excellent at 2-years follow-up. LEVEL OF EVIDENCE: Level 2, Retrospective Cohort Study.

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Arthroscopic anterior cruciate ligament reconstruction with semitendinosus graft versus peroneus longus tendon graft

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200735 ◽

2020 ◽

Vol 6 (2) ◽

pp. 386

Author(s):

Pudari Manoj Kumar ◽

Ishan Shevte ◽

Mukesh Phalak ◽

Abhishek Nair ◽

Parth .

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Tendon Graft ◽

Collateral Ligament ◽

Peroneus Longus Tendon ◽

Longus Tendon ◽

Peroneus Longus ◽

Anterior Cruciate ◽

Tendon Autograft

Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction can be performed using autograft from various sources namely, bone patellar tendon graft, hamstring tendons (semitendinosus, gracilis) or peroneus longus tendon.Methods: A prospective study of 30 patients who underwent arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft and peroneus longus tendon autograft during the study period.Results: Statistically, there is very little comparable difference between semitendinosus and peroneus longus when used for arthroscopic ACL reconstruction. However, peroneus longus tendon shows superior results when used in patients with grade 3 medial collateral ligament (MCL) injury combined with ACL injury.Conclusions: Our study brings forth the superior efficacy and quality of the double stranded peroneus longus tendon especially in cases associated with complicated injuries involving the medial collateral ligament with a follow up date of about 2 years and as a healthy supplement to other choices of autografts and revision cases.

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Preliminary Results in Anatomic All-inside Anterior Cruciate Ligament Reconstruction

Journal of Interdisciplinary Medicine ◽

10.1515/jim-2016-0050 ◽

2016 ◽

Vol 1 (s2) ◽

pp. 23-26

Author(s):

Octav Russu ◽

Tiberiu Bățagă ◽

Andrei-Marian Feier ◽

Radu Prejbeanu ◽

Radu Fleaca ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Knee Laxity ◽

Clinical Results ◽

Lysholm Score ◽

X Rays ◽

The Mean ◽

Anterior Cruciate

Abstract Introduction: Anterior cruciate ligament (ACL) rupture is one of the most common lesions in knee traumatology; therefore the number of ACL reconstructions is increasing worldwide. Usually, an anteromedial (AM) accessory portal is required in anatomical positioning of the femoral tunnel, which is not absolutely necessary in this technique. Aim: Assessment of all-inside ACL reconstruction preliminary clinical results with adjustable loops and buttons on both femoral and tibial surfaces. Method: Our prospective study included 28 subjects (19 male, 9 female) with chronic ACL ruptures. The mean age of the study population was 27.72 ± 8.23 years. In all cases ACL reconstruction was carried out with the use of quadrupled semitendinosus auto-grafts with adjustable loops and buttons on the femoral and tibial surfaces and anatomic placement of both tunnels, using an outside-in technique, with flipcutters (Arthrex®). Clinical and radiological evaluations were carried out before surgery and at 3 and 6 months postoperatively, with the Lysholm scoring system, the Tegner activity scale and anterior-posterior and latero-lateral X-rays. Anterior knee laxity was measured in 25° of flexion using a portable arthrometer (RolimeterTM, Aircast®) and maximum manual force. Results: During the final follow-up, the Lysholm score was good and excellent in 27 cases, with a mean Lysholm score of 95.55 ± 4.63; all results were classified as good. The mean preoperative Tegner activity score was 3.46 ± 1.71 (range: 1-7), and the post-operative mean score was 5.75 ± 2.24 (range: 2-10). We found no graft ruptures. Preoperative knee laxity measurements showed a mean displacement of 11.5 ± 3.1 mm and side-to-side differences of 5.6 ± 3.5 mm, while the postoperative measurements at the last follow-up were 6.3 ± 1.54 mm and 2.65 ± 1.86 mm, respectively. Conclusion: Short-term clinical outcomes of all-inside ACL restoration with anatomic placement femoral and tibial tunnels seem to recommend this surgical option, with good subjective and objective results. Additional research will have to prove the long-term success.

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Arthroscopic Transphyseal Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

Journal of Orthopaedic Surgery ◽

10.1177/1602400307 ◽

2016 ◽

Vol 24 (3) ◽

pp. 307-311 ◽

Cited By ~ 8

Author(s):

Luca Dei Giudici ◽

Roberto Fabbrini ◽

Luca Garro ◽

Serena Arima ◽

Antonio Gigante ◽

...

Keyword(s):

Acl Reconstruction ◽

Cruciate Ligament ◽

Lysholm Score ◽

Leg Length ◽

Adolescent Athletes ◽

Ikdc Score ◽

The Mean ◽

Anterior Cruciate ◽

Tegner Activity Scale

Purpose To evaluate the 5-year outcome of arthroscopic transphyseal anterior cruciate ligament (ACL) reconstruction in 19 adolescent athletes. Methods 14 male and 5 female adolescent athletes aged 12 to 16 (mean, 13.9) years with Tanner stage 2 or 3 open physes underwent arthroscopic transphyseal ACL reconstruction by a single surgeon and were followed up for 5 years. Patients were evaluated using the numerical rating score (NRS) for pain, knee osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, and Lysholm Score, as well as the leg length discrepancy, femorotibial alignment, varus or valgus deformities, active and passive knee range of motion. Results At 5-year follow-up, physes were closed in all patients. The mean NRS for pain improved from 7.2 to 1.6; the KOOS improved from 55.3 to 88; the mean IKDC score improved from 34.5 to 84; the mean Tegner Activity Scale improved from 2.7 to 8.2 and was comparable with that before injury (8.4); and the mean Lysholm score improved from 36.3 to 84.6. All except 2 patients returned to their pre-injury level of sports activity after a mean of 25 weeks. The 2 exceptions had a 2+ Jerk test and a 3+ Lachman test; one of them also had positive signs for a lateral meniscal lesion. Both had sustained a second trauma not long before the 5-year follow-up. Two patients had reduced sensitivity in the anteromedial aspect of the proximal third of the tibia. One patient had leg length discrepancy of +1.5 cm owing to overgrowth response of the physis. Conclusion Transphyseal ACL reconstruction is a viable option for skeletally immature patients, with high reproducibility, a high rate of return to sport, and a low incidence of growth disturbance. Early surgery can prevent the onset of meniscal lesions and early osteoarthritis.

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Higher Rate of Patellofemoral Problems After Anterior Cruciate Ligament Reconstruction using Hamstring Autograft

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6626 ◽

2021 ◽

Vol 9 (B) ◽

pp. 811-815

Author(s):

Krisna Yuarno Phatama ◽

Romy Darmawansa ◽

I Gusti Ngurah Arga Aldrian Oktafandi ◽

Felix Cendikiawan ◽

Alva Pribadi ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Single Bundle ◽

Hamstring Autograft ◽

Peroneus Longus Tendon ◽

Peroneus Longus ◽

Kujala Score ◽

Anterior Cruciate ◽

Tendon Autograft

Background: Patellofemoral problems are not uncommon among post-anterior cruciate ligament (ACL) reconstruction patients. Hamstring autograft harvesting-related factor is one of the suspected causes. A lack of tibiofemoral internal rotation force due to strength deficit causes the patella tends to shift laterally. Purposes: Peroneus longus tendon has been proposed as an alternative graft source due to its adequate tensile strength and minimal donor site morbidity to the knee biomechanics, including the patellofemoral joint. This tendon does not cross the knee joint and thus does not affect patellofemoral alignment and biomechanics. This study aims to compare patellofemoral problems between hamstring and peroneus longus autograft harvested-patients following ACL reconstruction. Material and methods: Thirty-one subjects who underwent primary single-bundle ACL reconstruction between September 2018 and September 2019 and met the inclusion criteria were grouped into the hamstring group (n=16) and peroneus longus group (n=15). Both groups were evaluated retrospectively. The follow-up assessment was conducted on the phase II rehabilitation program. The assessed variables were pain, crepitus, and the Indonesian-validated Kujala score. Results: No significant differences in pain and crepitus were found between both groups. There were significant differences in the Kujala score between both groups (P < .001). The peroneus longus group reported an averagely higher score than the hamstring group. Conclusion: Single bundle ACL reconstruction using peroneus longus tendon autograft produces less patellofemoral symptoms and functional limitation than using hamstring tendon autograft.

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Evaluation of Donor Ankle Function after Harvesting Peroneus Longus Tendon Graft for Anterior Cruciate Ligament Reconstruction- A Prospective Cohort Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49882.15383 ◽

2021 ◽

Author(s):

Mamata Manjari Sahu ◽

Arul S Pragassame ◽

Patitapaban Mohanty ◽

Pabitra Kumar Sahoo

Keyword(s):

Cruciate Ligament ◽

Tendon Graft ◽

P Value ◽

Foot And Ankle ◽

Peroneus Longus Tendon ◽

Longus Tendon ◽

Peroneus Longus ◽

Anterior Cruciate ◽

Ankle Function

Introduction: Primary full thickness Peroneus Longus Tendon Graft (PLTG) for Anterior Cruciate Ligament Reconstruction (ACLR) has been used with good clinical outcome. Recently, it is designated as a promising graft option for ACLR. The effect of harvesting PLTG on donor ankle function is still not completely understood. Peroneus Longus Tendon (PLT) is thought to play a major role in proprioceptive regulation of the ankle joint. All the studies till date did cross-sectional assessments of ankle and foot function at or after 6 months that might have overlooked the timely detection of donor site morbidities. Aim: To evaluate the ankle function and compare the affected and sound limb function in subjects with an ACLR with autologous PLTG starting at an early postoperative visit upto six months. Materials and Methods: A prospective cohort study was conducted at a tertiary rehabilitation centre from March 2019 to March 2021 including the follow-up evaluation. As per the inclusion criteria, 63 participants after ACLR with PLTG were considered for assessment using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot scale and Foot and Ankle Ability Measure (FAAM) scale at 6 weeks, 3 months and 6 months post-ACLR follow-up. Comparison between sound and affected limbs was done during all follow-ups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 18.0. Both FAAM and AOFAS ankle and foot scores were analysed with non parametric tests. Results: Mean age of 63 participants were 29.25 years. Median of AOFAS and FAAM score at 6 week, 3 month, and 6 month post- ACLR follow-ups were (88, 98 and 100) and (97.22, 98.80 and 100), respectively. Statistically significant increase in AOFAS and FAAM scores were observed at 3 month and 6 month as compared to 6 week follow-ups with p=0.001 and p-value=0.001 respectively. The group comparison between the affected and sound side functional scores at different study visits showed statistically significant greater values for the sound ankle than the affected ankle (FAAM: 6 week: p-value=0.001; 3 month: p-value=0.001; 6 month: p-value=0.001 and AOFAS p-value=0.001; p-value=0.001; p-value=0.001, respectively). Conclusion: The evaluation of functional outcomes showed gradual and linear improvement at subsequent postoperative visits and restores fully to 100% at 6 month indicating a near- normal to normal donor ankle function following ACLR with PLTG by 6 months. The group comparison showed only marginal but significant difference between affected and sound ankle function.

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All-Inside Anterior Cruciate Ligament Reconstruction Using an Anterior Half of the Peroneus Longus Tendon Autograft

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121991226 ◽

2021 ◽

Vol 9 (6) ◽

pp. 232596712199122

Author(s):

Mingguang Bi ◽

Chen Zhao ◽

Qiong Zhang ◽

Li Cao ◽

Xinji Chen ◽

...

Keyword(s):

Acl Reconstruction ◽

Cruciate Ligament ◽

Donor Site ◽

International Knee Documentation Committee ◽

Donor Site Morbidity ◽

Peroneus Longus Tendon ◽

Ankle Eversion ◽

Anterior Cruciate ◽

American Orthopaedic

Background: The peroneus longus tendon (PLT) has been used as a graft in many orthopaedic surgical procedures because of its comparable biomechanical strength with the native anterior cruciate ligament (ACL). Despite its potential, few studies have been performed to investigate the clinical reliability of ACL reconstruction using a PLT autograft. Purpose: To assess the clinical outcomes and donor-site morbidity of ACL reconstruction using an anterior half of the PLT (AHPLT) autograft in patients with an isolated ACL injury. Study Design: Case series; Level of evidence, 4. Methods: Between January 2016 and January 2017, a total of 21 patients with an isolated ACL injury underwent all-inside single-bundle ACL reconstruction using an AHPLT autograft. Knee stability was assessed using the Lachman test, pivot-shift test, and KT-2000 arthrometer (side-to-side difference) with 134-N anterior force and at 30° of knee flexion. Knee function was evaluated using the International Knee Documentation Committee score, Lysholm score, and Tegner score. Donor-site morbidity was assessed using ankle eversion and plantarflexion strength as well as the American Orthopaedic Foot & Ankle Society scoring system and the Foot and Ankle Disability Index. Results: At a mean final follow-up of 40.1 months (range, 36-48 months), the KT-2000 arthrometer side-to-side difference was significantly lower compared with preoperatively (1.1 ± 0.62 vs 7.0 ± 2.18 mm, respectively; P < .001). The mean preoperative International Knee Documentation Committee, Lysholm, and Tegner scores were 52.0 ± 8.27, 50.9 ± 8.50, and 1.8 ± 0.87, respectively, increasing significantly to 94.2 ± 2.61, 95.2 ± 2.64, and 6.8 ± 1.50, respectively, at final follow-up ( P < .001 for all). All patients had grade 5 muscle strength in ankle eversion and plantarflexion at the donor site, with mean American Orthopaedic Foot & Ankle Society and Foot and Ankle Disability Index scores of 96.8 and 97.6, respectively. No complications or reoperations occurred. Conclusion: All-inside ACL reconstruction using an AHPLT autograft produced good functional scores and stability without obvious ankle-site morbidity.

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Single-Bundle versus Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial with 6-Year Follow-up

The Journal of Knee Surgery ◽

10.1055/s-0037-1598176 ◽

2017 ◽

Vol 30 (09) ◽

pp. 898-904 ◽

Cited By ~ 10

Author(s):

Francesco Dini ◽

Laura de Girolamo ◽

Massimo Cattani ◽

Michele Rosa ◽

Paolo Adravanti

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Femoral Tunnel ◽

Cruciate Ligament ◽

Double Bundle ◽

Lysholm Score ◽

Single Bundle ◽

Randomized Controlled ◽

Anterior Cruciate

AbstractSingle-bundle (SB) anterior cruciate ligament (ACL) reconstruction is increasingly used in a large number of patients and it allows obtaining very good clinical and subjective results; however, functional tests show a persistent rotational instability. Biomechanical studies seem to indicate that double-bundle (DB) ACL reconstruction allows to obtain increased anterior and rotational stability compared with SB. The aim of this prospective randomized controlled study was to compare the clinical outcome and the possible osteoarthritic evolution of patients treated either with a SB (freehand transtibial femoral tunnel) or with a DB technique (outside-in for posterolateral femoral tunnel/inside-out for anteromedial femoral tunnel) at a final follow-up of 6 years. A total of 60 patients with complete ACL rupture (age, 16–40 years) were prospectively randomized to SB (n = 30) or DB (n = 30) groups. Patients were evaluated preoperatively and after surgery at 6 months, 1, 3, and 6 years with Lysholm score, International Knee Documentation Committee (IKDC) form, and KT-2000 (Medmetric Corp). The degree of osteoarthritis (OA) based on the Kellgren–Lawrence grade was also assessed. No significant differences in background factors between the two groups were observed. Homogeneity was also found in term of preoperative Lysholm score, IKDC, and KT-2000 between SB and DB groups. After 6 months from surgery, both groups showed significant improvements for Lysholm, IKDC, and KT-2000 score with respect to preoperative observations (p < 0.001); however, no significant differences have been observed in term of postoperative values between SB and DB groups at each time point (6-year evaluation: Lysholm score 98.14 ± 10.03 and 97.22 ± 12.82; IKDC normal + nearly normal 95 and 100%; KT-2000 1.68 ± 1.26 and 1.03 ± 1.92 for SB and DB, respectively; all p > 0.05). At the final follow-up, three patients (11.11%) in the DB group and two patients (7.69%) in the SB group presented signs of OA progression. Our study did not reveal any advantages in using DB ACL reconstruction in mid- to long-term follow-up in term of clinical outcome and knee stability, as well as in term of OA progression.

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COMPARATIVE STUDY OF SINGLE BUNDLE ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE PERONEUS LONGUS TENDON AUTOGRAFT VERSUS HAMSTRING TENDON AUTOGRAFT

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i9.2188 ◽

2021 ◽

Vol 5 (9) ◽

Author(s):

Pankaj Jain ◽

Rajesh Kumar Kushwaha ◽

Ahteshyam Khan ◽

Prashant Modi ◽

Hari Saini

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Functional Score ◽

Peroneus Longus Tendon ◽

Longus Tendon ◽

Peroneus Longus ◽

Anterior Cruciate ◽

Tendon Autograft ◽

Graft Diameter

Introduction: Arthroscopic anterior cruciate ligament (ACL) reconstruction can be performed using autograft from various sources namely bone patellar tendon bone graft, hamstring graft, or peroneus longus tendon. Purpose of this study was to compare the clinical outcome and donor site morbidity of ACL reconstruction with peroneus longus tendon versus hamstring tendon autograft in patients with an isolated ACL injury. Methods: Patients who undervent isolated single bundle ACL reconstruction were allocated in peroneus and hamstring groups and observed prospectively. Functional score (IKDC, & Modified Cincinnati score) was recorded preoperatively and 1 year post-operatively. Graft diameter was measured intra-operatively. Donor site morbidity were assessed with thigh circumference measurments and ankle scoring by MRC grading and FADI Score. Results: 56 patients (28-Hamstring and 28-peroneus group) met the inclusion criteria. The average Peroneus longus graft diameter (8.8±0.8) was significantly larger than the Hamstring graft diameter (8.1±0.9). In terms of 1-year postoperative outcomes statistically there is very little comparable difference between both these grafts when used for arthroscopic ACL reconstruction. Conclusion: Our study brings forth the superior efficacy and quality of double stranded peroneus longus tendon autograft in term of good functional score (IKDC, & Modified Cincinnati score), larger graft diameter, less thigh hypotrophy, and excellent ankle function based on FADI Score. Prospective cohort study, level II. Abbreviations: ACL- Anterior cruciate ligament BPTB- Bone-patellar tendon-bone IKDC – International knee documentation committee FADI- Foot and ankle disability index.

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Peroneus Longus Tendon Autograft is a Safe and Effective Alternative for Anterior Cruciate Ligament Reconstruction

The Journal of Knee Surgery ◽

10.1055/s-0038-1669951 ◽

2018 ◽

Vol 32 (08) ◽

pp. 804-811 ◽

Cited By ~ 5

Author(s):

Fu-Dong Shi ◽

Daniel Edward Hess ◽

Jin-Zeng Zuo ◽

Shi-Jie Liu ◽

Xue-Chen Wang ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Biomechanical Testing ◽

Peroneus Longus Tendon ◽

Longus Tendon ◽

Peroneus Longus ◽

Functional Scores ◽

Anterior Cruciate ◽

Grade Iii

AbstractThe ipsilateral peroneus longus tendon (PLT) was utilized as an autograft for anterior cruciate ligament (ACL) reconstruction of patients with acute ACL rupture and grade III medial collateral ligament (MCL) injury. We investigated the efficacy and safety of this alternative autograft compared with autologous hamstring tendon (HT). Biomechanical testing of the graft options was performed and compared with the native ACL. Thirty-eight patients with acute ACL ruptures and grade III MCL injuries were treated with ACL reconstruction with a doubled autologous PLT or quadrupled autologous HT. Knee stability and function was evaluated clinically with the Lachman test and KT-2000 arthometer as well as subjectively with functional scores. Effects on the donor ankle were evaluated by biomechanical testing. The ultimate tensile strengths of doubled PLT and quadrupled HT were significantly higher than that of the native ACL and the ultimate tensile strength of doubled PLT was comparable with that of quadrupled HT. There were no significant differences in clinical or functional scores between the two groups. There were no significant differences in pre- and postoperative biomechanical testing of the donor ankle. PLT is a suitable alternative autograft for an ACL reconstruction in patients with a concomitant grade III MCL injury without a significant biomechanical disadvantage to the ankle donor site.

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