Functional Outcome of Unilateral Peroneus Longus Autograft in Arthroscopic Anterior Cruciate Ligament Reconstruction
DOI:
https://doi.org/10.51253/pafmj.v73i6.6932Keywords:
Anterior cruciate ligament reconstruction, Arthroscopy, Peroneus longus autograftAbstract
Objective: To evaluate the functional outcome of unilateral peroneus longus autograft in arthroscopic anterior cruciate
ligament reconstruction
Study Design: Cross-sectional study.
Place and Duration of Study: Orthopedic Department, Combined Military Hospital, Lahore Pakistan, from Jul 2020 to Jun
2021.
Methodology: We included all the patients who underwent ipsilateral peroneus longus autograft for anterior cruciate ligament reconstruction. Fixation was achieved with a bio-absorbable screw on the tibial side and an endobutton on the femoral side. Lateral or medial menisectomy was performed according to the requirement. Post-op X-rays were done to assess the position of the endobutton and tibial tunnel. Eight millimetres tunnels were drilled, and the tendon was tailored accordingly. Results were assessed for pain, infection, range of motion and instability after three months of surgical procedure.
Results: A total of 52 patients were included in the final analysis. The mean age of the study participants was 33.36±6.353
years. At the end of three months, pain 6(11.5%) and restricted range of motion 6(11.5%) were the common untoward
outcomes reported by the patients. High body mass index and lack of engagement in physiotherapy had a statistically
significant relationship with the presence of untoward outcomes in our study (p-value<0.05).
Conclusion: Peroneus longus is a strong, robust autograft for anterior cruciate ligament reconstruction with excellent
functional results. Very few patients had untoward effects, and those, too, were of mild intensity. Patients with high body
mass index and those not engaging in physiotherapy emerged as high-risk patients for having untoward effects after the
surgery.
Downloads
References
Petersen W, Fink C, Kopf S. Return to sports after ACLreconstruction: A paradigm shift from time to function. Knee Surg Sports Traumatol Arthros 2017; 25(5): 1353-1355.https://doi.org/10.1007/s00167-017-4559-x.
Paterno MV, Flynn K, Thomas S, Schmitt LC. Self-Reported FearPredicts Functional Performance and Second ACL Injury AfterACL Reconstruction and Return to Sport: A Pilot Study. Sports
Health 2018; 10(3): 228-233.https://doi.org /10.1177/1941738117745806.
Amin S, Guermazi A, LaValley M, Niu J, Clancy M, Hunter D, etal. Complete anterior cruciate ligament tear and the risk for
cartilage loss and progression of symptoms in men and womenwith knee osteoarthritis. Osteoarthr Cartil 2008; 16(8): 897-902.https://doi.org /10.1016/j.joca.2007.11.005.
Orlando Júnior N, de Souza Leão M, de Oliveira N. Diagnosis ofknee injuries: comparison of the physical examination and
magnetic resonance imaging with the findings from arthroscopy.Rev Bras Ortop 2015; 50(6): 712-719..https://doi.org/10.1016/j.rboe.2015.10.007.
Evans J, Nielson Jl. Anterior Cruciate Ligament Knee Injuries.
Treasure Island (FL): StatPearls Publishing; 2021.
Khandelwal K, Chaturvedi V, Mishra V, Khandelwal G.
Diagnostic accuracy of MRI knee in reference to arthroscopy in
meniscal and anterior cruciate ligament injuries. Egypt J Radiol
Nucl Med 2018; 49(1): 138-145.
Ahmed ZT, Khan NH, Bilal S, Ameer S, Tanveer F, Tanveer M, et
al. Diagnostic accuracy of magnetic resonance imaging for
detection of anterior cruciate ligament tears taking arthroscopy
as gold standard. Med Forum 2020; 31(3): 31-34.
Mok YR, Wong KL, Panjwani T, Chan CX, Toh SJ, Krishna L, et
al. Anterior cruciate ligament reconstruction performed within
months of the index injury is associated with a lower rate of
medial meniscus tears. Knee Surg Sports Traumatol Arthrosc
; 27(1): 117-123. https://doi.org /10.1007/s00167-018-5027-y.
Mardani-Kivi M, Karimi-Mobarakeh M, Keyhani S, SahebEkhtiari K, Hashemi-Motlagh K, Sarvi A, et al. Hamstring tendon
autograft versus fresh-frozen tibialis posterior allograft in
primary arthroscopic anterior cruciate ligament reconstruction: a
retrospective cohort study with three to six years follow-up. Int
Orthop 2016; 40(9): 1905-1911.
https://doi.org /10.1007/s00264-016-3164-9.
Rhatomy S, Asikin AIZ, Wardani AE, Rukmoyo T, Lumban-Gaol
I, Budhiparama NC, et al. Peroneus longus autograft can be
recommended as a superior graft to hamstring tendon in singlebundle ACL reconstruction. Knee Surg Sports Traumatol
Arthrosc 2019; 27(11): 3552-3559.
https://doi.org /10.1007/s00167-019-05455-w.
Trung DT, Manh SL, Thanh LN, Dinh TC, Dinh TC. Preliminary
result of arthroscopic anterior cruciate ligament reconstruction
using anterior half of peroneus longus tendon autograft. Open
Access Maced J Med Sci 2019; 7(24): 4351-4356.
https://doi.org /10.3889/oamjms.2019.390.
Trung DT, Manh SL, Thanh LN, Dinh TC, Dinh TC. Preliminary
result of arthroscopic anterior cruciate ligament reconstruction
using anterior half of peroneus longus tendon autograft. Open
Access Maced J Med Sci 2019; 7(24): 4351-4356.
https://doi.org 10.3889/oamjms.2019.390.
Sahu NK, Patnaik S, Nanda S, Jain M. Variables determining the
postoperative knee range of motion following cruciatesubstituting total knee replacement: A prospective study. Cureus
; 11(8): e5501. https://doi.org /10.7759/cureus.5501.
Kopkow C, Lange T, Hoyer A, Lützner J, Schmitt J. Physical tests
for diagnosing anterior cruciate ligament rupture. Cochrane
Database Syst Rev 2018; 2018(12): CD011925.
https://doi.org /10.1002/14651858.CD011925.pub2’
He J, Tang Q, Ernst S, Linde MA, Smolinski P, Wu S, et al.
Peroneus longus tendon autograft has functional outcomes
comparable to hamstring tendon autograft for anterior cruciate
ligament reconstruction: a systematic review and meta-analysis.
Knee Surg Sports Traumatol Arthrosc 2020; 27(1): 1-5.
https://doi.org /10.1007/s00167-020-06279-9.
Rhatomy S, Asikin AIZ, Wardani AE, Rukmoyo T, Lumban-Gaol
I, Budhiparama NC, et al. Peroneus longus autograft can be
recommended as a superior graft to hamstring tendon in singlebundle ACL reconstruction. Knee Surg Sports Traumatol
Arthrosc 2019; 27(11): 3552-3559.
https://doi.org /10.1007/s00167-019-05455-w.
Kumar VK, Narayanan SK, Vishal RB. A study on peroneus
longus autograft for anterior cruciate ligament reconstruction. Int
J Res Med Sci 2020; 8(1): 183-188.
https://doi.org/10.18203/2320-6012.ijrms20195904.
Mo Z, Li D, Yang B, Tang S. Comparative efficacy of graft
options in anterior cruciate ligament reconstruction: A systematic
review and network meta-analysis. Arthrosc Sports Med Rehabil
; 2(5): e645-e654.
https://doi.org /10.1016/j.asmr.2020.05.007.