Assessment of Functional Outcome of Peroneus Longus Tendon Autograft Versus Hamstring Tendon Autograft in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Comparative Randomised Control Trial Study in a Tertiary Care Center in Chengalpettu Distri

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure to restore knee stability following injury. The choice of graft plays a crucial role in the functional outcome of the procedure. While hamstring tendon (HT) autografts have been widely used, the peroneus longus tendon (PLT) has recently emerged as an alternative with potential biomechanical advantages and lower donor-site morbidity. This study aims to compare the functional outcomes of ACL reconstruction using peroneus longus tendon autografts versus hamstring tendon autografts through a randomized controlled trial (RCT).

Methods: Conducted in the rural areas of Chengalpattu district, Tamil Nadu, this study included 36 patients (18 in each group) with Grade II or III ACL injuries confirmed through clinical and radiological assessments. Participants were randomly assigned to receive either PLT or HT autografts for ACL reconstruction. Functional outcomes were evaluated preoperatively and postoperatively at 3, 6, and 9 months using the Lysholm knee score, International Knee Documentation Committee (IKDC) evaluation, and other objective measures. Secondary outcomes included graft-specific strength testing, knee stability assessments, pain scores, and donor-site morbidity evaluation.

Results: Both groups demonstrated significant functional improvement postoperatively. At 9 months, the PLT group exhibited higher Lysholm scores (89.8 ± 3.2 vs. 86.5 ± 3.4, p = 0.03) and better knee flexion strength (96.2 ± 3.1% vs. 92.7 ± 3.5%, p = 0.02). The PLT group also reported lower donor-site pain and minimal strength deficits compared to the HT group. No significant differences were observed in knee stability, return to activity, or overall patient satisfaction.

Conclusion: Peroneus longus tendon autografts provide comparable, and in some aspects superior, functional outcomes compared to hamstring tendon autografts in ACL reconstruction. PLT may be a viable alternative, particularly in reducing donor-site morbidity and improving postoperative knee strength. Further studies with larger sample sizes and long-term follow-up are warranted.