Arthroscopic anterior cruciate ligament reconstruction with meniscal repair: single-sitting versus multiple-staged-functional outcome analysis
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20254226Keywords:
Anterior cruciate ligament, Peroneus longus tendon, LysholmAbstract
Background: Anterior cruciate ligament (ACL) injuries are frequently associated with meniscal tears. Management can be performed either as a single sitting procedure (ACL reconstruction with concomitant meniscal repair) or in staged operations. The optimal strategy regarding functional recovery remains debated. The purpose of this study was to compare functional outcomes of single sitting versus multiple sitting arthroscopic ACL reconstruction with meniscal repair using peroneus longus tendon (PLT) autograft.
Methods: A prospective comparative study was conducted on 30 patients aged 18–50 years with ACL rupture and repairable meniscal tears, treated between November 2023 and November 2025. Patients were divided into two groups: group A (n=15) underwent single sitting ACL reconstruction with meniscal repair, and group B (n=15) underwent staged procedures. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) score and Lysholm score at baseline and at 12 months.
Results: All patients completed a minimum follow-up of 12 months. Both groups showed significant improvement from baseline. IKDC: 84.8±6.4 (group A) versus 82.1±6.8 (group B), p=0.21. Lysholm: 89.4±5.2 (group A) versus 86.7±5.6 (group B), p=0.19. Median time to return to sport was 7 months in group A and 9 months in group B. No graft re-ruptures were reported. Meniscal healing failure occurred in 1 patient (6.7%) in group A and 2 patients (13.3%) in group B.
Conclusion: Single sitting arthroscopic ACL reconstruction with meniscal repair using peroneus longus tendon autograft provides functional outcomes comparable to multiple sitting procedures, with the added advantage of earlier return to sport. It is a safe and effective option in appropriately selected patients.
References
Soleymanha M, Soleymani Nejad A, Keyhani S, Vosoughi F, LaPrade RF, Tollefson LV. Peroneus longus tendon harvest for ACL reconstruction yields good functional outcome of the ankle: A systematic review and meta-Analysis. Knee Surg Sports Traumatol Arthrosc. 2025;30.
Chen C, Jing Z, Li Z, Hu M, Bei C, Xin L. Comparative efficacy of different lengths of anterior cruciate ligament stump during reconstruction with peroneus longus tendon. BMC Surg. 2025;25(1):175.
Zhao Z, Tang L, Chen J, Bai X, Chen Y, Ng L, et al. The effect of harvesting the anterior half of the peroneus longus tendon on foot morphology and gait. J Orthop Surg Res. 2024;19(1):69.
Sadoghi P, Widhalm HK, Fischmeister MF, Leitner L, Leithner A, Fischerauer SF. Delayed Meniscus Repair Lowers the Functional Outcome of Primary ACL Reconstruction. J Clin Med. 2024;13(5):1325.
Sudhakar T, Raja CR, Jambukeswaran PST, Ugeneshwaran M, Jeyaraman M. Functional outcome of arthroscopic anterior cruciate ligament reconstruction with autologous graft. Indian J Orthop Surg. 2021;7(2):113-7.
Ashish S, Ravindra C, Aditya D, Ashish P. Outcome after arthroscopic meniscal repair. D Y Patil J Health Sci. 2024;12(3):91-7.
Gofer AS, Alekperov AA, Gurazhev MB, Avdeev AK, Lukinov VL, Rubtsov DV, et al. Peroneus longus tendon autograft for one-stage revision ACL reconstruction: midterm results. Trauma Orthopaed Russia. 2024;30(2):82-96.
Butt U, Vuletic F, Shaikh MAA, Amanullah, Rehman GU, Shah IA, et al. 5-years outcomes following arthroscopic anterior cruciate ligament reconstruction comparing quadruple hamstring and peroneus longus tendon autografts: a randomized control trial. Arch Orthop Trauma Surg. 2024;145(1):85.
Khalid MN, Janjua SN, Sheraz M, Kanwal S, Ghouri QM, Shaheen UU. Quantifying donor-site morbidity in anterior cruciate ligament reconstruction using peroneus longus tendon autograft. J Musculoskelet Surg Res. 2024;8:349-53.
Zhao Z, Tang L, Chen J, Bai X, Chen Y, Ng L, et al. The effect of harvesting the anterior half of the peroneus longus tendon on foot morphology and gait. J Orthop Surg Res. 2024;19(1):69.
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