Early Outcomes of Anterior Cruciate Ligament Reconstruction Using Autologous Peroneus Longus Tendon

Background Anterior cruciate ligament (ACL) reconstruction using autologous grafts is a well-established treatment for ACL injuries. Recently, the peroneus longus tendon (PLT) has gained attention as a potential autograft due to its favorable biomechanical properties and low donor-site morbidity. Methods This prospective study evaluated the early clinical outcomes of ACL reconstruction using autologous PLT in adult Egyptian male patients, focusing on knee function and donor-site foot biomechanics. A total of 115 patients underwent arthroscopic ACL reconstruction and were assessed using the International Knee Documentation Committee (IKDC) and the American Orthopaedic Foot and Ankle Society (AOFAS) scores at 1, 3, and 6 months postoperatively. Results IKDC scores showed a statistically significant improvement over time (p < 0.001). AOFAS scores demonstrated a transient postoperative decline followed by recovery to near-baseline levels by the 6-month follow-up. Minor complications were noted, including edema in 9.5% of patients and superficial infection in 1.7%, with no reported cases of nerve injury. Overall, PLT provided reliable functional restoration with minimal impact on donor-site biomechanics. Conclusion ACL reconstruction using autologous PLT is a safe and effective alternative to hamstring tendon autografts. The procedure resulted in significant improvement in knee function and range of motion, with negligible adverse effects on donor-site function or ankle biomechanics.