DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20184382

Functional outcome of arthroscopic reconstruction of anterior cruciate ligament tear using peroneus longus tendon autograft

B. L. Khajotia, Shakti Chauhan, Rajendra Sethia, B. L. Chopra

Abstract


Background: The objective of the study was to evaluate the functional outcome of arthroscopic reconstruction of ACL tear using triple layered PLT autograft and to study its effect on ankle stability.

Methods: The study included 25 patients. The range of age was 18-42 years. Pre-op clinical tests and MRI was done to confirm tear. Reconstruction was done arthroscopically. Physiotheraphy protocol was fixed for all patients. Final outcome was assessed at 6 months using IKDC score and ankle stability was assessed by grading muscle power (MRC grading) with the normal side as control.

Results: IKDC score was normal or near normal in 21 patients and only 4 patients were rated as abnormal or severely abnormal. Mean IKDC Score was 83.53. Stability of the ACL was assessed using the Lachman test: normal in 18 cases (72%), 1+ laxity in 5 cases (20%), 2+ and 3+ in 1 case (4%) each. Pivot shift was negative in 15 cases (60%), Pivot glide was seen in 9 cases (36%) and gross pivot shift was seen in 1 patient. Partial meniscectomy of the medial meniscus was performed in 5 patients. No patient experienced ankle dysfunction however 2 patients had pressure pain in the region of the graft harvest.

Conclusions: PLT graft is similar to the native ACL both in terms of thickness and strength. It can be an appropriate autograft option for ACL reconstruction without compromising ankle function and avoiding potential complications of hamstring and BPTB autograft obtained from the knee region.


Keywords


ACL, PLT, Arthroscopy, Autograft

Full Text:

PDF

References


Freeman JW, Kwansa AL. Recent Advancements in Ligament Tissue Engineering: The Use of Various Techniques and Materials for ACL Repair. Recent Patents Biomed Engineering. 2008;1:18-23.

Kerimoğlu S, Aynaci O, Saraçoğlu M, Aydin H, Turhan AU. Anterior cruciate ligament reconstruction with the peroneus longustendon. Actaorthoptraumatol Turc. 2008;42(1):38-43.

Nazem K, Barzegar M, Hosseini A, Karimi M. can we use peroneus longus tendon in addition to hamstring tendons for anterior cruciate ligament reconstruction. Adv Biomed Res. 2014;3:115.

Angthong C, Chernchujit B, Apivatgaroon A, Chaijenkit K, Nualon P, Suchao-in K. ACL reconstruction with peronuslongustendon: Abiomechanical and clinical evaluation of donor ankle morbidity. J Med Assoc Thai. 2015;98:6.

Zhao J, Huangfu X. The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft source. Am J Sports Med. 2012;40(3):662-71.

Hefti F, Muller W, Jakob RP, Staubli HU. Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports TraumatolArthrosc 1993;34(1):226-34.

Gordon MD, Steiner ME: Anterior cruciate ligament injuries: Orthopaedic Knowledge Update Sports Medicine III, Garrick JG (Ed), American Academy of Orthopaedic Surgeons, Rosemont; 2004: 169.

Hospodar SJ, Miller MD: Controversies in ACL reconstruction: bone patellar tendon-bone anterior cruciate ligament reconstruction remains gold standard. Sports Med Arthrosc. 2009;17(4):242-6.

Poehling-Monaghan KL, Salem H, Ross KE, Secrist E, Ciccotti MC, et al. Long-Term Outcomes in Anterior Cruciate Ligament Reconstruction: A Systematic Review of Patellar Tendon Versus Hamstring Autografts. Orthop J Sports Med. 2017;5(6):2325967117709735.

Chee MY, Chen Y, Pearce CJ, Murphy DP, Krishna L, Hui JH, et al. Outcome of Patellar Tendon Versus 4-Strand Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Prospective Randomized Trials. Arthroscopy. 2017;33(2):450-63.

Kartus J, Movin T, Karlsson J. Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy. 2001;17:971-80.

Shelton WR, Papendick L, Dukes AD. Autograft versus allograft anterior cruciate ligament reconstruction. Arthroscopy. 1997;13:446-9.

Batty LM, Norsworthy CJ, Lash NJ, Wasiak J, Richmond AK, Feller JA. Synthetic devices for reconstructive surgery of the cruciate ligaments: a systematic review. Arthroscopy. 2015;31(5):957-68.

Cao HB, Liang J, Xin JY. Treatment of anterior cruciate ligament injury with peroneus longus tendon. Zhonghua Yi Xue Za Zhi. 2012;92(35):2460-2.

Mayr HO, Benecke P, Hoell A, Schmitt-Sody M, Bernstein A, Suedkamp NP, et al. Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: A Comparative 2-Year Follow-up. Arthroscopy. 2016;32(1):34-42.