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Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity

Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin)
INDIA

Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity

Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), INDIA Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, INDIA Lakshmana Das Sekar, MS, DNB Orthopaedics, INDIA Arghya Kundu Choudhury, MS, MCh Joint replacement and reconstruction, INDIA

All India Institute of Medical Sciences Bathinda, Bathinda, Uttarakhand, INDIA

2021 Congress ePoster Presentation rating (2)

Anatomic Location

Knee

Anatomic Structure

Ligaments Tendon

Diagnosis / Condition

Instability

Treatment / Technique

Autograft

Ligaments

ACL PCL Posterolateral Corner

Diagnosis Method

MRI

Sports Medicine

Outcome Studies

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Summary: Peroneus longus graft can be considered as a potential autograft option for ACL reconstruction

Background

The choice of an appropriate autologous graft becomes difficult in cases of revision ACL surgeries or multi-ligament reconstructions, where more than one tendon may be needed. Allografts can be used in such situations but they are not easily available, and carry a small but definite risk of transmission of blood-borne infections and a higher rate of graft rupture. Peroneus longustendon (PLT) is gaining popularity as a graft option in knee ligament reconstructions, showing clinical outcomes comparable to quadrupled hamstring grafts.

Objectives
This study aims to assess the functional outcomes, donor site morbidity and ankle strength after using ipsilateral peroneus longus autograft for anterior cruciate ligament (ACL) reconstruction in cases of revision ACL and multiligament injuries.

Study Design & Methods
This was a prospective observational study. All of the patients were evaluated by clinical examination for knee for laxity, ankle joint stability, and using visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) score, and Lysholm score, preoperatively and postoperatively at two-year follow-up. Morbidity of donor ankle was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score, bilateral evertors, and first ray plantar-flexion strength measurement using an isometer (Innovative Design Orthopaedics) at two-year follow-up.
Ankle range of motion was started soon after pain relief and no specific rehabilitation changes were made for PLT harvest.

Results

Ipsilateral PLT graft was used in ten patients of revision ACL reconstruction, and 27 patients of the multi-ligament ligament knee injury. The mean length of PLT harvested (cm) was 26.2 (standard deviation 2.6, range 22-31), and mean diameter of the doubled graft (mm) was 7.9 (standard deviation 0.68, range 7.5-8.5). There was a significant improvement in VAS score for pain, Lysholm, and IKDC scores (p=<0.001) at two -year follow-up. There were no cases of graft failure, superficial or deep infection.
Ankle dorsiflexion(p=0.1), ankle plantarflexion (p=0.21), eversion strength(p=0.13), first ray plantarflexion strength(p=0.26), and AOFAS score(p=0.29) were found to be comparable to the normal side in all patients. ??None of the patients complained of hypoaesthesia around the graft harvest site on clinical examination. Ankle range of motion was comparable on both sides.

Conclusions

PLT autograft had sufficient length and diameter while using in ACL reconstruction. Peroneus longus graft can be considered as a potential autograft option for ACL reconstruction in multi-ligament knee injuries and revision ACL reconstruction. No donor site morbidity was seen as PLT harvesting didn’t affect the ankle range of motion and evertor or first ray plantarflexion strength at follow up.

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Relationship Between Posterior Tibial Slope And Sagittal Plane Mechanics During Jump Landing After Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Robert A. Duerr, MD, UNITED STATES Jennifer Perry, MS, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES Benjamin Ormseth, BS, UNITED STATES Robert Siston, PhD, UNITED STATES Andrew Garrone, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Laura C. Schmitt, PT, PhD, FAPTA, UNITED STATES
Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort Abstract Presentation 6 minutes Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Jillian Lee, BHB, MBChB, FRACS (Ortho), NEW ZEALAND Yoong Lim, BEng, PhD, AUSTRALIA Quang Dao, FRACS, AUSTRALIA
Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction. Abstract Presentation 6 minutes Franco Della Vedova, ARGENTINA Hernan Galan, MD, ARGENTINA Daniel A. Slullitel, MD, Prof., ARGENTINA
Acl Deficiency Influences Medio-Lateral Tibial Alignment And Knee Varus–Valgus During In Vivo Activities Abstract Presentation 3 minutes Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Alberto Grassi, PhD, ITALY Marco Bontempi, PhD, ITALY Erika Pinelli, MsC, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up ePoster Presentation Thomas R. Pfeiffer, Prof., GERMANY Julius Stüber, cand. med., GERMANY Jan-Hendrik Naendrup, BS, MD, GERMANY Daniel Guenther, MD, Prof., FACS, MHBA, GERMANY Robin Otchwemah, MD, GERMANY Sven T. Shafizadeh, Prof. Dr. , GERMANY Paola Kappel, MD, GERMANY Arasch Wafaisade, PD, GERMANY Sebastian Imach, MD, MBA, GERMANY
Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee Abstract Presentation 6 minutes Yasunari Oniki, MD, PhD, JAPAN Taiki Murakami, JAPAN Eiichi Nakamura, MD, PhD, JAPAN
Tunnel Position In Anterior Cruciate Ligament Reconstruction Varies Between High Volume And Low Volume Surgeons Abstract Presentation 6 minutes Jonathan D Hughes, MD, PhD, UNITED STATES Christopher M. Gibbs, MD, UNITED STATES Akere Atte, MD, PharmD, UNITED STATES Anmol Almast, BS, UNITED STATES Mikael Sansone, MD, PhD, SWEDEN Jon Karlsson, MD, PhD, Prof., SWEDEN Volker Musahl, MD, Prof., UNITED STATES
Adding A Lateral Extra-Articular Tenodesis Significantly Reduces Acl Graft Rupture Rates In Pediatric And Adolescent Patients When Compared To Isolated Acl Reconstruction Abstract Presentation 5 minutes Andrea Ferretti, Prof., ITALY Adnan Saithna, MD, FRCS, UNITED STATES Alessandro Carrozzo, MD, ITALY Alessandro Annibaldi, MD, ITALY Fabio Marzilli, MD, ITALY Edoardo Monaco, MD, ITALY
Tranexamic Acid Has No Effect On Post-Operative Hemarthrosis Or Pain Control Following Acl Reconstruction Using Bone Patella Tendon Bone Autograft: A Double-Blinded Randomized Control Trial Abstract Presentation 5 minutes Jordan W Fried, BM, UNITED STATES David Bloom, BA, UNITED STATES Eoghan T. Hurley, MB, BCh, MCh, IRELAND Samuel Baron, MD, UNITED STATES Kirk Anthony Campbell, MD, UNITED STATES Eric Jason Strauss, MD Laith M. Jazrawi, MD, UNITED STATES Michael J Alaia, MD, UNITED STATES
High Rate of Initially Overlooked Kaplan Fiber Complex Injuries in Patients With Isolated Anterior Cruciate Ligament Injury Abstract Presentation 5 minutes Ryan M Bell, BS, UNITED STATES Daniel P. Berthold, Association.-Prof., GERMANY Lukas Willinger, MD, GERMANY Matthew R. Levasseur, MD, UNITED STATES Daniel Marrero, MD, UNITED STATES Lukas Nawid Muench, MD, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Elmar Herbst, MD, PhD, GERMANY Mark P. Cote, PT, DPT, MSCTR, UNITED STATES Robert A. Arciero, MD, UNITED STATES Cory M. Edgar, MD, PhD, UNITED STATES

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Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity

Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity

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Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity

Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity

Background

Results

Conclusions

More ISAKOS 2021: Global Content