scholarly journals Anterior Cruciatel Ligament Reconstruction with Peroneus Longus Tendon Autograft: Functional Outcome and Donor Site Morbidity

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0008
Author(s):  
Auliana Hayu Kusumastutia ◽  
Tedjo Rukmoyo ◽  
Sholahuddin Rhatomy ◽  
Yudha Mathan Sakti
Keyword(s):  
Functional Outcome ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Hamstring Tendon ◽  
Donor Site Morbidity ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Cruciate

Anterior Cruciate Ligament (ACL) is a knee ligament that is very important in maintaining the stability of the knee joint. The incidence of isolated ACL tears remain a common orthopaedic injury with significant increase in the rate of ACL reconstruction over time. Several types of autografts used for ACL reconstruction have some potential occurrence of donor site morbidity, including Bone-Patellar Tendon-Bone (BPTB), hamstring tendon, and quadriceps tendon. Peroneus longus tendon can be an option as a graft donor because it has biomechanical characteristics that are not significantly different from the hamstring tendon. Purpose: The aim of the study was to evaluate the functional outcome and donor site morbidity of anterior cruciate ligament (ACL) reconstruction using peroneus longus tendon autograft. Methods: This study was an observational analytical with retrospective cohort design using medical record. The functional outcomes were assessed with IKDC, Modified Cincinnati, Tegner-Lysholm, and KSS scoring system 12 months after surgery. Donor site morbidity was assessed with AOFAS and FADI scoring system, eversion strength, and plantarflexion strength. Results: Seventy five patients fulfilled the inclusion criteria (59 males and 16 females). Mean of peroneus longus tendon graft diameters were 8.39 ± 0.69 mm (range 6.5-10 mm). Significant increase of functional score (p<0.05) were found 12 months after surgery. Mean score of IKDC was 55.26 ± 12.76 preoperative; 96.69 ± 3.36 postoperative, Modified Cincinnati was 65.45 ± 16.25 preoperative; 93.29 ± 7.04 postoperative, Tegner-Lysholm was 67.80 ± 15.29 preoperative; 89.71 ± 8.35 postoperative, KSS (Knee) was 65.33 ± 19.46 preoperative; 95.17 ± 5.94 postoperative, and KSS (Function) was 76.52 ± 20.25 preoperative; 93.20 ± 10.29 postoperative. Mean score of AOFAS was 98.93 ± 3.11 and FADI was 99.80 ± 0.59 at six months after surgery. The eversion and plantarflexion strength were not significantly different (p>0.05) between donor and contralateral side ankle. There was neurapraxia in 3 (4%) patients at six months postoperative. Conclusion: The peroneus longus tendon can be an ideal source of graft for ACL reconstruction because it has good functional outcome and minimal donor site morbidity.

scholarly journals Eversion and First Ray Plantarflexion Muscle Strength in Anterior Cruciate Ligament Reconstruction Using a Peroneus Longus Tendon Graft

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711987246 ◽  
Author(s):  
Sholahuddin Rhatomy ◽  
Fidelis H. Wicaksono ◽  
Noha Roshadiansyah Soekarno ◽  
Riky Setyawan ◽  
Shinta Primasara ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Ankle Eversion ◽  
Significant Difference ◽  
First Ray

Background: The peroneus longus tendon has been used as a graft in orthopaedic reconstruction surgery because of its comparable biomechanical strength with the native anterior cruciate ligament (ACL) and hamstring tendon. However, one of the considerations in choosing an autograft is donor site morbidity. Purpose/Hypothesis: This study aimed to compare ankle eversion and first ray plantarflexion strength between the donor site and its contralateral site after ACL reconstruction. The study hypothesis was that strength measurements will be different between the harvest site and contralateral healthy site. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent ACL reconstruction using a peroneus longus tendon autograft between March 2017 and December 2018 were included in this study. Patients followed a rehabilitation protocol from the first day after surgery. Ankle eversion and first ray plantarflexion strength were measured using a modified dynamometer 6 months after surgery. Donor site morbidity was assessed 6 months after surgery using the Foot & Ankle Disability Index (FADI) and American Orthopaedic Foot & Ankle Society (AOFAS) scoring system for the ankle and hindfoot. Results: A total of 31 patients (22 male, 9 female; mean age, 27.58 ± 8.69 years [range, 18.00-45.00 years]) fulfilled the inclusion criteria. There was no significant difference in ankle eversion strength at the donor site compared with the contralateral site ( P = .55), with means of 65.87 ± 7.63 N and 66.96 ± 8.38 N, respectively. Also, there was no significant difference in ankle first ray plantarflexion strength at the donor site compared with the contralateral site ( P = .68), with means of 150.64 ± 11.67 N and 152.10 ± 12.16 N, respectively. The mean FADI score of 99.71 ± 0.57 and mean AOFAS score of 98.71 ± 3.03 at the donor site were considered excellent results. Conclusion: Ankle eversion and first ray plantarflexion strength at the donor site were similar to those at the contralateral healthy site, with no donor site morbidity. This suggests that the peroneus longus tendon is a promising graft in ACL reconstruction.

scholarly journals A study on peroneus longus autograft for anterior cruciate ligament reconstruction

2019 ◽  
Vol 8 (1) ◽  
pp. 183
Author(s):  
Kumar V. K. ◽  
Narayanan S. K. ◽  
Vishal R. B.
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Donor Site ◽  
International Knee Documentation Committee ◽  
Donor Site Morbidity ◽  
Knee Function ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Almost All

Background: To compare the clinical outcome and donor site morbidity of ACL reconstruction with Peroneus longus tendon autografts in patients with isolated ACL injury.Methods: This was a prospective study that included patients who underwent ACL reconstruction using Peroneus longus tendon autograft. Results were assessed via physical examination. Donor site morbidity of the foot and ankle after tendon harvesting was assessed using Medical Research Council (MRC) grading of ankle and foot movements.  Post-operative knee function was evaluated by the International Knee Documentation Committee (IKDC) scoring.Results: In this study sample of 25 patients, the ankle functions at the donor site are grossly preserved in almost all the patients, which was elucidated by grading the power of foot eversion. Post operatively knee function (IKDC scoring) were rated as normal in 92% (23 cases).Conclusions: Peroneus longus is an appropriate autograft source for ACL reconstruction in view of ease of harvest, adequate size, cosmetically appealing, considering excellent post-operative knee scores. And removing the Peroneus longus tendon has no effect on gait parameters and does not lead to instability of the ankle. So, it can be used as an autogenous graft in orthopaedic surgeries.

scholarly journals Functional Outcome of Chronic Anterior Cruciate Ligament Rupture Reconstruction Using Peroneus Longus Tendon Graft According to AOFAS and IKDC Score: A Case Series

2021 ◽  
Vol 3 (4) ◽  
pp. 18-23
Author(s):  
Rizki Zainuraditya ◽  
I Gusti Ngurah Wien Aryana
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcome ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Tendon Graft ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Cruciate

Introduction: The anterior cruciate ligament (ACL) is a crucial ligament structure of the knee that plays a significant role in knee joint stability and competitive sports performance. In order to reestablish knee stability, ACL reconstruction (ACLR) in the presence of rupture has been recognized as the most common surgical management procedure. Case: This study reported six cases of chronic ACL rupture reconstruction using peroneus longus tendon graft. All patients underwent an arthroscopic ACL repair procedure in Sanglah Hospital Bali. In terms of functional outcome, all patients were assessed using the scoring of AOFAS for the ankle and IKDC for the knee. Result: The functional outcomes of the IKDC and AOFAS score were good from all six patients who already underwent ACL reconstruction using peroneus longus graft with a minimum follow-up of one year. Discussion: Chronic ACL ruptures were successfully treated using the peroneus longus tendon graft. Intraoperatively, there were no significant problems from the harvested peroneus longus tendon graft and ACL reconstruction with the graft. All patients showed no complications, including the local infection following the operation. Rehabilitation procedure post-ACL reconstruction was performed at the Rehabilitation Unit in Sanglah General Hospital. Conclusion: Peroneus longus tendon graft is considered a suitable choice of graft for ACL reconstruction. It presented satisfactory results, effectiveness, and safety based on the AOFAS and IKDC scores.

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

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

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.

Peroneus Longus Tendon Autograft: A Promising Graft for ACL Reconstruction

2021 ◽  
Vol 1 (4) ◽  
pp. 263502542110098
Author(s):  
Nicolaas C. Budhiparama ◽  
Sholahuddin Rhatomy ◽  
Krisna Yuarno Phatama ◽  
William Chandra ◽  
Asep Santoso ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Donor Site ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Skin Incision ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Tendon Autograft ◽  
Primary Acl Reconstruction

Background: With the increasing use of hamstring tendon as an autograft in anterior cruciate ligament (ACL) reconstruction, some shortcomings have been found on the donor site. Therefore, an alternative autograft option with adequate strength and less donor site morbidity will be very valuable. Peroneus longus tendon has been found to be a promising option. Indication: Primary ACL reconstruction. Technique Description: Peroneus longus tendon graft is harvested with a longitudinal skin incision at 2 to 3 cm (2 finger-breadths) above and 1 cm (1 finger-breadth) behind the lateral malleolus, followed by superficial fascia incision in line with skin incision. The peroneus longus and peroneus brevis tendons were then identified. The tendon division location was marked at 2 to 3 cm above the level of the lateral malleolus. After that, an end-to-side suture was performed between the distal part of the peroneus longus tendon and peroneus brevis tendon. The peroneus longus tendon was stripped proximally with a tendon stripper to at least 5 cm from the fibular head to prevent peroneal nerve injury. Graft preparation was performed with a standard procedure to obtain the suitable graft size. In routine arthroscopic ACL reconstruction, peroneus longus tendon graft fixation can be performed with a cortical suspension device, bioabsorbable screws, or a combined technique. Results: Recent studies showed that peroneus longus autograft had a comparable outcome with hamstring tendon autograft in primary ACL reconstruction at a 1-year follow-up. The use of peroneus longus tendon autograft resulted in larger graft diameter and less thigh hypotrophy. The mean (±SD) for the AOFAS-Hindfoot Score in the peroneus longus group was 97.3 ± 4.2, while the mean FADI score was 98 ± 3.4, both of which were considered excellent results. Discussion/Conclusion: The use of peroneus longus autograft in primary ACL reconstruction is a safe procedure with an excellent outcome. Peroneus longus tendon autograft can be recommended as an alternative graft in single-bundle ACL reconstruction. Further study of the functional outcome and knee stability evaluation is recommended.

scholarly journals Anterior Half of the Peroneus Longus Tendon Combined with Semitendinosus and Gracilis Tendons for Anterior Cruciate Ligament Reconstruction: An Athlete Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Diego Escudeiro de Oliveira ◽  
Melanie Mayumi Horita ◽  
Marconde de Oliveira e Silva ◽  
Victor Eduardo Roman Salas ◽  
Pedro Baches Jorge
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Hamstring Tendon Graft ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Half ◽  
Anterior Cruciate

In clinical practice, it is observed that the hamstring tendon graft, despite being first choice in knee ligament reconstruction, may not present adequate size. Therefore, it becomes necessary to search for other graft alternatives. In this context, the peroneus longus tendon arises as an option to replace or complement other grafts. The surgeon can opt to use the tendon in its totality or only its anterior half, presenting adequate length, diameter, and biomechanics, without major repercussions for the donor site. In this study, we report a case of an athlete in which the autologous hamstring tendon graft did not present the adequate diameter for anterior cruciate ligament reconstruction. It was, then, necessary to use the anterior half of the peroneus longus tendon.

scholarly journals Comparing the Stiffness of Peroneus Longus Tendon Versus Hamstrings in Anterior Cruciate Ligament Reconstruction: A Biomechanical Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sholahuddin Rhatomy ◽  
Hendrian Chaniago ◽  
Faiz Alam Rasyid ◽  
Krisna Yuarno Phatama
Keyword(s):  
Tensile Strength ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Biomechanical Study ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Mean Diameter ◽  
The Mean

Background: The use of autografts originating from either hamstring tendons or peroneus longus tendons is a surgical option in anterior cruciate ligament (ACL) reconstruction. Objectives: This research aimed to compare the tensile strength between the hamstring tendon and the peroneus longus tendon in ACL reconstruction. The hypothesis of this study was: Peroneus longus grafts have tensile strength equal to hamstring grafts based on living donor patients. Methods: This cross-sectional study was a biomechanical study examining means and standard deviations (SD) by comparing the tensile strength of peroneus longus tendons and hamstring tendons when used as autograft donors in ACL reconstruction. Results: In this study, 51 patients with reconstructive ACL were enrolled. The mean diameter of the hamstring tendon was 7.86 with SD ± 0.69, while the mean diameter of peroneus longus tendon was 7.67 with SD ± 0.63. The mean diameter of the peroneus longus graft was not significantly different. The mean displacement on the hamstring tendon was 2.44 with SD ± 0.42, while the peroneus longus tendon was 2.06 with SD ± 0.14. The peroneus longus tendon had significantly more tensile strength compared to the hamstring tendon. Conclusions: Diameter of the peroneus longus graft was not significantly different from the hamstring graft. However, the peroneus longus graft had more tensile strength than the hamstring graft based on living donor patients.

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