Clinical outcomes of peroneus longus tendon and contralateral hamstring tendon autografts in revision anterior cruciate ligament reconstruction

Purpose: This study aimed to compare the clinical and functional outcomes of revision anterior cruciate ligament reconstruction (ACLR) performed with ipsilateral peroneus longus tendon (PLT) autograft or contralateral hamstring tendon (HT) autograft.Materials and Methods: Patients who underwent arthroscopic revision ACLR between 2019 and 2023 were retrospectively reviewed. After applying the exclusion criteria, 32 patients were included: 14 treated with PLT autograft and 18 with contralateral HT autograft. Demographic data, graft diameter, time to return to daily activities, return to sports, Lachman grade, Lysholm score, International Knee Documentation Committee (IKDC) score, donor-site ankle function, and complications were evaluated. Results: PLT group had a larger graft diameter than the contralateral HT group (8.9 ± 0.8 mm vs 7.9 ± 0.5 mm). Final Lysholm and IKDC scores were similar between groups (84.4 ± 6.5 vs 81.7 ± 8.1 and 81.4 ± 7.7 vs 79.9 ± 8.3, respectively), and both groups showed clear improvement from baseline. Time to return to daily activities was also similar (4.3 ± 1.3 months vs 4.2 ± 1.2 months), and return to sports was achieved in 57.1% of the PLT group and 55.6% of the contralateral HT group. Conclusion: PLT autograft showed short-term clinical and functional outcomes similar to those observed with contralateral HT autograft in revision ACLR, while providing a larger graft diameter with clinically acceptable donor-site morbidity.