Comparative study of the functional outcome of semitendinosus graft versus peroneus longus graft in arthroscopic reconstruction surgeries of anterior cruciate ligament
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231993Keywords:
ACL, Autograft, IKDC, Lysholm knee score, Peroneus longus, SemitendinosusAbstract
Background: ACL disruption is the commonest ligamentous knee injury among active adults, invariably leading to changes in knee kinematics which are most likely to result in secondary degenerative changes and long-term functional impairment. Thus, due to the ACL's crucial role as the primary restraint against anterior tibial translation, its reconstruction using varying graft options are being extensively studied for better functional outcome.
Methods: In this prospective study, we analysed 30 patients having ACL tear (clinically and radiographically) and treated with arthroscopic reconstruction of ACL. Among these, 15 cases were operated using semitendinosus graft and 15 cases by using peroneus longus tendon graft. The study was conducted in a tertiary care hospital from January 2021 to June 2022 with minimum follow up of 6 months and maximum follow up of 15 months.
Results: Mean Lysholm score (post op) in Group ST was 90.6±3.18 and in Group PLT was 92.2±2.65. The Lysholm Score and IKDC grading between the two groups was comparable and showed no significant difference. Post-Op laxity assessed using the Lachman’s grading showed normal findings in 70% patients, and of the remaining 30% (9 patients), 5 patients from ST group and 4 patients from PLT group showed 1+ laxity at follow up examination.
Conclusions: Arthroscopy assisted ACL reconstruction with peroneus longus tendon autograft provides a steady knee, reduces postoperative donor site morbidity and enables early rehabilitation, similar to the traditional semitendinosus tendon autograft.
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References
Cor van der Hart P, Michel PJ, van den Bekerom, Thomas Patt W. The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament. J Orthop Surg Res. 2008;3(1):24.
Nebelung W, Wuschech H. Thirty-five years of follow-up of anterior cruciate ligament-deficient knees in high-level athletes. Arthroscopy: J Arthros Relat Surg. 2005;21(6):696-702.
Gillquist J, Messner K. Anterior cruciate ligament reconstruction and the long term incidence of gonarthrosis. Sports Med. 1999;27:143-56.
Widner M, Dunleavy M, Lynch S. Outcomes following ACL reconstruction based on graft type: are all grafts equivalent?. Curr Revi Musculosk Med. 2019;12:460-5.
Frank CB, Jackson DW. Current concepts review-the science of reconstruction of the anterior cruciate ligament. JBJS. 1997;79(10):1556-76.
Thomas AC, Wojtys EM, Brandon C, Palmieri-Smith RM. Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction. J Sci Med Sport. 2016;19(1):7-11.
Kerimoglu S, Aynaci O, Saracoglu M, Aydin H, Turhan A. Anterior cruciate ligament reconstruction with the peroneus longus tendon. Acta Orthop Traumatol Turc. 2008;42(1):38-43.
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 Sport Med. 2012;40(3):662-71.
Rhatomy S, Asikin AI, Wardani AE, Rukmoyo T, Lumban-Gaol I, Budhiparama NC. Peroneus longus autograft can be recommended as a superior graft to hamstring tendon in single-bundle ACL reconstruction. Knee Surg Spo Traumatol Arthros. 2019;27:3552-9.
Bourke HE, Gordon DJ, Salmon LJ, Waller A, Linklater J, Pinczewski LA. The outcome at 15 years of endoscopic ACL reconstruction using hamstring tendon autograft. J Bone Joint Surg Br. 2012;94(5):630-7.
Cao HB, Liang J, Xin JY. Treatment of anterior cruciate ligament injury with peroneus longus tendon. Zhongh Yi Xue Za Zhi. 2012;92(35):2460-2.
Sharma D, Agarwal A, Shah K, Shah R, Shah H. Peroneus longus: Most promising autograft for arthroscopic ACL reconstruction. Indian J Orthop Surg. 2019;5(3):172-5.
Kumar VK, Narayanan SK, Vishal RB. A study on peroneus longus autograft for anterior cruciate ligament reconstruction. Int J Res Med Sci. 2020;8(1):183-8.
He J, Tang Q, Ernst S, Linde MA, Smolinski P, Wu S, Fu F. Peroneus longus tendon autograft has functional outcomes comparable to hamstring tendon autograft for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2021;29(9):2869-2879.
Kim DK, Park G, Kadir KB, Kuo LT, Park WH. Comparison of knee stability, strength deficits, and functional score in primary and revision anterior cruciate ligament reconstructed knees. Sci Repor. 2018;8(1):9186.
Rhatomy S, Wicaksono FH, Soekarno NR, Setyawan R, Primasara S, Budhiparama NC. Eversion and first ray plantarflexion muscle strength in anterior cruciate ligament reconstruction using a peroneus longus tendon graft. Orthop J Spor Med. 2019;7(9):2325967119872462.
Williams III RJ, Laurencin CT, Warren RF, Speciale AC, Brause BD, O'Brien S. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction: diagnosis and management. Am J Sports Med. 1997;25(2):261-7.
Stucken C, Garras DN, Shaner JL, Cohen SB. Infections in anterior cruciate ligament reconstruction. Sports Health. 2013;5(6):553-7.
Bi M, Zhao C, Zhang S, Yao B, Hong Z, Bi Q. All-inside single-bundle reconstruction of the anterior cruciate ligament with the anterior half of the peroneus longus tendon compared to the semitendinosus tendon: a two-year follow-up study. J Knee Surg. 2018;31(10):1022-30.
Torg JS. Conrad W, Kalen V – Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med. 1976;4:84-91.
Park CH, Lee WC. Donor site morbidity after lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon autograft. Am J Sports Med. 2017;45(04):922-8.
Rahnemai-Azar AA, Sabzevari S, Irarrázaval S, Chao T, Fu FH. Anatomical individualized ACL reconstruction. Arch Bone Jt Surg. 2016;4(04)291-7.
Xu H, Zhang C, Zhang Q, Du T, Ding M, Wang Y, et al. A systematic review of anterior cruciate ligament femoral footprint location evaluated by quadrant method for single-bundle and double-bundle anatomic reconstruction. Arthroscopy: J Arthrosc Rela Surg. 2016;32(8):1724-34.