Uso del tendón peroneo lateral largo para la reconstrucción del LCA: evaluación de la morbilidad del sitio dador

Abstract

Introduction: reconstruction of the ACL has conventionally been approached through various graft reconstructions, such as the patellar tendon graft (BPTB), the quadruple hamstring tendon graft (STG), the quadriceps tendon (QT), or occasionally with allografts (Allo), among others. However, all these grafts are associated with many complications. The use of the peroneus longs tendon (PLT) was first described by Kerimoğlu et al. in 2008. Functional comparative results obtained by He et al. between BPTB and PLT position the latter as a valid alternative for ACL reconstruction, as it provided better clinical results in the knee, although with a slightly lower American Orthopaedic Foot and Ankle Society (AOFAS) score compared to the preoperative score.

Objective: to present our initial experience using the peroneus longus tendon (PLT) as an alternative in anterior cruciate ligament (ACL) reconstructions, evaluating donor site morbidity.

Materials and methods: between June 2023 and July 2024, twenty-nine anterior cruciate ligament reconstructions were performed using the peroneus longus tendon as the graft of choice. The inclusion criteria for evaluating donor site morbidity were having completed three months postoperatively. Patients with chronic ankle instability or flatfoot on the side to be operated on were excluded. Donor site morbidity was evaluated using the AOFAS score and the FADI score.

Results: seventeen patients met the inclusion criteria (follow-up of more than three months). The mean AOFAS score at three months was 92.25 ± 5.18, and the mean FADI score was 94.37 ± 4.18, with no significant differences between revision and primary reconstructions or between sexes.

Conclusion: in our case series, our clinical results are similar to those of current literature in the evaluation at three months post-surgery using PLT for ACL reconstruction. With low donor site morbidity and functional outcomes like those of usual autografts in the long term, we could consider it as a valid option, particularly in revision cases where primary plastic was performed using grafts around the knee. Mid-term and long-term results are under study.