Harvesting of Peroneus Longus Tendon Autograft

Autografts are always used in anterior cruciate ligament (ACL) reconstruction. Traditional sources, such as hamstring tendons, bone-patellar tendon-bone, and quadriceps tendon, are popular choices but may result in muscle imbalances and dynamic differences in knee kinematics. The peroneus longus tendon (PLT) has emerged as an alternative autograft for ACL reconstruction, offering comparable functional outcomes and avoiding interference with the flexor-extensor complexes of the knee. However, concerns about donor site paresthesia and ankle dysfunction have been raised in PLT harvesting. This article presents a detailed protocol for safely and effectively obtaining this autograft. The protocol emphasizes critical steps, modifications, and potential troubleshooting methods. In this study, we assessed functional scores, donor paresthesia, and other complications in 20 patients six months after PLT harvesting. Our findings indicate that this protocol for PLT acquisition did not result in significant complications. Therefore, we confirm the effectiveness of this protocol and offer guidance on essential preoperative preparations and surgical techniques.