Clinical and Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction with Semitendinosus Graft versus Peroneus Longus Tendon Graft: A Prospective Comparative Study

Introduction: Anterior cruciate ligament (ACL) injuries are usually treated with arthroscopic ACL reconstruction. There are many graft options used for the procedure. Most commonly used autograft options are hamstring, patella tendon and quadriceps. Recently, peroneus longus (PL) tendon harvest is gaining interest but for the additional donor site morbidity at the ankle. We compared the graft dimensions, donor site morbidities, and knee functional outcome of patients who underwent ACL reconstruction with either hamstring or PL tendon. Methods: We conducted a hospital based prospective observational study in our institute. Patients who underwent arthroscopic ACL reconstruction were divided into two groups randomly (Semitendinosus [ST] and PL). Graft length and diameter were recorded intraoperatively. The postoperative knee clinical and functional outcome were assessed at regular intervals postoperative till 1 year using International Knee Documentation Committee (IKDC) and Tegner Lysholm scores. Donor site morbidity was assessed with thigh circumference and ankle scoring was done with AOFAS and foot and ankle disability index (FADI) scoring systems. Results: Fifty-two patients were enrolled in the study; 26 each in ST and PL groups. The mean tendon length and diameter was larger in PL group. Knee function based on Lysholm and IKDC scores did not show any significant differences across PL and ST tendon groups at 1-year follow-up. There was a significant improvement in AOFAS and FADI scores in the PL group at the end of 1 year. The decrease in thigh circumference was considerably more significant in the ST tendon group than in PL group at a minimum of 1-year follow-up. Conclusion: PL can be an excellent autograft option. The donor site morbidity was lesser, graft dimensions are larger and functional results are comparable with that of ST at the end of 1 year.