Anterior Half Versus Full-Length Peroneus Longus Tendon Grafts in Knee Ligament Reconstruction: A Comparative Study of Morphology and Donor Site Morbidity
D.E. De Oliveira, J.M.D. Malpaga, S.M.D.G. Canuto, V.B.C. De Padua, C. Santili, P.B. JorgeObjectives:
To compare functional outcomes, graft morphology, and donor-site impact between the full peroneus longus tendon (PL) and the anterior half peroneus longus tendon (AHPL) used as grafts in anterior cruciate ligament (ACL) reconstruction with adjunctive procedures.
Methods:
This retrospective comparative study included 114 patients who underwent ACL reconstruction between April 2019 and May 2022. Patients received either a PL graft (n = 75) or an AHPL graft (n = 39), in addition to hamstring tendons. Functional outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and the Foot and Ankle Disability Index (FADI) at 6 and 24 months postoperatively. Graft length and diameter were recorded intraoperatively and correlated with anthropometric variables.
Results:
The mean graft length and diameter were 24.16 ± 2.04 cm and 13.05 ± 2.51 mm for the PL group, and 22.86 ± 2.00 cm and 11.97 ± 2.59 mm for the AHPL group, respectively. Both groups demonstrated significant and comparable improvements in AOFAS and FADI scores at all follow-up points. No statistically significant correlation was identified between graft dimensions and patient height or weight. No clinically relevant differences in ankle function were observed between groups.
Conclusion:
Both the peroneus longus and anterior half peroneus longus tendons are reliable graft options for ACL reconstruction, providing comparable graft characteristics and excellent functional outcomes. Harvesting the anterior half of the peroneus longus tendon may reduce potential donor-site morbidity while preserving graft effectiveness.