Reconstruction of Anterior Cruciate Ligament Using Peroneus Longus Autograft. Systematic Review

Abstract Background ACLR provides surgical restoration of the injured ACL using the placement of graft material. The choice of graft is principal in providing optimal knee stability after surgery. Peroneus longus tendon PLT is an autograft modality that offers unique benefits for ACL reconstruction cases. Aim of the Work Our study was conducted to evaluate. PLT as an autograft modality benefits in ACL reconstruction and asses if this modality has any complications. Post-operative biomechanical outcomes were evaluated using the International Knee Documentation Committee (IKDC) and the American Orthopedic Foot and Ankle Score (AOFAS) score. Materials and Methods In our metaanalysis, 11 studies were included evaluating the outcome of the Anterior Cruciate Ligament Reconstruction with the Peroneus Longus Tendon. The total number of patients was 600 patients. The mean age was 29 years. Results The mean follow up time was 24 month our results revealed that: functional outcomes using PLT autograft were satisfactory. There was a significant difference between the mean pre-operative and postoperative IKDC scores with a mean difference 30.50, statistically significant decrease in AOFAS after PLT harvest was identified, PLT harvest does not appear to affect foot and ankle function to any clinically significant degree. In our meta-analysis there was non significant decrease in FADI score. The use of peroneus longus tendon graft in ACL reconstruction did not cause significant changes or major complications at the donor ankle site. Complications in the form of infection were detected only in three studies. Re-rupture was detected only in one study. Conclusion ACL reconstruction with peroneus longus autograft has an excellent functional score. Excellent results were achieved in both the knee and the donor site according to the Modified Cincinnati, International Knee Documentation Committee (IKDC) and Lysholm scores, American Orthopedic Foot and Ankle Score (AOFAS). Foot and Ankle Disability Index (FADI) showed insignificant change between pre-operative and post-operative scores. PLT autograft is a suitable alternative graft choice from outside the knee for patients undergoing ACL reconstruction.