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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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Acl - Pcl Fixation Sequence During Multi-Ligament Knee Reconstruction Does Not Affect Knee Laxity Abstract Presentation 6 minutes Carola F. van Eck, MD, PhD, FAAOS, UNITED STATES Aly Maher Fayed, MD, EGYPT Ryo Kanto, MD, JAPAN Taylor M. Price, MS, UNITED STATES Michael Dinenna, BS, UNITED STATES Monica A. Linde, MSIE, RN, UNITED STATES Patrick J. Smolinski, PhD, 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
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
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
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
The Effect Of Lateral Extraarticular Tenodesis On In Vivo Cartilage Contact In Combined Anterior Cruciate Ligament Reconstruction ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Tom Gale, MS, UNITED STATES Daisuke Chiba, MD, PhD, JAPAN Felipe Martin Suntaxi, MS, UNITED STATES Bryson P. Lesniak, MD, UNITED STATES Freddie H. Fu, MD, UNITED STATES William Anderst, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Nerve injury during anterior cruciate ligament reconstruction: A comparison between patellar and hamstring tendon grafts harvest Abstract Presentation 5 minutes Jonathan Singer, MD, ISRAEL Ehud Rath, Prof., ISRAEL Mustafa Yassin, MD, ISRAEL Shlomo Bronak, MD, ISRAEL Barak Haviv, MD, ISRAEL
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
Early ROM exercise after ACLR with hamstring autograft does not cause joint laxity : A Prospective Randomized Controlled Trial, 2 years follow up ePoster Presentation Jeong-Ku Ha, MD, phD, Prof, KOREA, REPUBLIC OF Kyu Sung Chung, MD, PhD, Prof., KOREA, REPUBLIC OF
Outcomes Following Anterior Cruciate Ligament Reconstruction in Young Patients: An Observational Study. ePoster Presentation Kunal Mohan, MB MCh MRCSI, IRELAND David Cooper, MB MRCSI, IRELAND Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Martin Davey, MB MCh MRCSI, IRELAND Megan Diack, MBCHB, MRCSI, MCh, IRELAND Paula McQuail, MB FRCSI, IRELAND Fintan J. Shannon, FRCS (Tr/Orth), IRELAND
Effect Of Graft Choice On 6-Year Outcomes Of Revision Anterior Cruciate Ligament Reconstruction In The Multicenter ACL Revision Study (Mars) Cohort Abstract Presentation 6 minutes Rick W. Wright, MD, UNITED STATES
Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada ePoster Presentation Yuba Raj Paudel, MPH, CANADA Mark F. Sommerfeldt, MD, CANADA Donald C. Voaklander, PhD, CANADA
The Outcome Of Non-circular (Rectangle, Oval) Femoral Tunnel ACL Reconstruction, Does It Improve The Outcome Of ACL Reconstruction Surgery? Abstract Presentation 6 minutes S. Ali Ghasemi, MD, UNITED STATES Joseph McCahon, DO, UNITED STATES Arthur R Bartolozzi, MD, UNITED STATES
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, 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