National Institute of Traumatology & Orthopedic Rehabilitation, (NITOR) Dhaka-1207, Bangladesh.
Medicine (Baltimore). 2023 Mar 3;102(9):e32943. doi: 10.1097/MD.0000000000032943.
Anterior cruciate ligament (ACL) tears are frequent ligamentous injuries that necessitate reconstruction in many cases. The patellar tendon and the hamstring tendon are the most frequently utilized autografts for reconstruction. However, both have certain disadvantages. We hypothesized that the peroneus longus tendon would be an acceptable graft for arthroscopic ACL reconstruction. The aim of this study is to determine whether a peroneus Longus tendon transplant is a functionally viable option for arthroscopic ACL reconstruction without compromising donor ankle activity. In this prospective study 439 individuals aged between 18 to 45 years, who underwent ACL reconstruction using ipsilateral Peroneus longus tendon autograft were observed. The injury to the ACL was initially assessed by physical examinations and further confirmed by magnetic resonance imaging (MRI). The outcome was assessed at 6, 12, and 24 months after the surgery using Modified Cincinnati, International Knee Documentation Committee (IKDC), and Tegner-Lysholm scores. The donor ankle stability was evaluated using foot and ankle disability index (FADI) and AOFAS scores, as well as hop tests. Significant (P < .001) improvement in the result of the IKDC score, Modified Cincinnati, and Tegner-Lysholm score was observed at the final follow-up. The Lachman test was mildly (1+) positive only in 7.70% of cases, the anterior drawer became negative in all cases, and the pivot shift test was negative in 97.43% of cases at 24 months after the surgery. FADI and AOFAS scores for donor's ankle functional assessment were impressive, as were single hop test, triple hop test, and cross over hop test results at 2 years. None of the patients had any neurovascular deficit. However, 6 cases of superficial wound infection were observed, 4 at the port site and 2 at the donor site. All resolved after appropriate oral antibiotic therapy. The peroneus longus tendon can be considered a safe, effective, and promising graft of choice for arthroscopic primary single-bundle ACL reconstruction because it has a good functional outcome and impressive donor ankle function after surgery.
前交叉韧带（ACL）撕裂是常见的韧带损伤，在许多情况下需要重建。髌腱和腘绳肌腱是最常被用于重建的自体移植物。然而，它们都有一定的缺点。我们假设腓骨长肌腱将是一种可接受的用于关节镜 ACL 重建的移植物，而不会影响供踝的活动度。在这项前瞻性研究中，观察了 439 名年龄在 18 至 45 岁之间的患者，他们均接受了同侧腓骨长肌腱自体移植物的 ACL 重建。ACL 的损伤最初通过体格检查进行评估，并通过磁共振成像（MRI）进一步确认。术后 6、12 和 24 个月分别使用改良 Cincinnati、国际膝关节文献委员会（IKDC）和 Tegner-Lysholm 评分评估结果。使用足部和踝关节残疾指数（FADI）和 AOFAS 评分以及跳跃测试评估供踝稳定性。在最终随访时，IKDC 评分、改良 Cincinnati 和 Tegner-Lysholm 评分的结果显著（P<.001）改善。Lachman 试验仅在 7.70%的病例中呈轻度（1+）阳性，在前抽屉试验中所有病例均为阴性，在 24 个月时，关节镜下前交叉韧带重建术后的髌股关节旋转试验（pivot shift test）均为阴性。供踝功能评估的 FADI 和 AOFAS 评分令人印象深刻，单足跳测试、三足跳测试和交叉跳测试结果也令人印象深刻。所有患者均无神经血管缺损。然而，观察到 6 例浅表伤口感染，其中 4 例位于端口部位，2 例位于供体部位。所有病例经适当的口服抗生素治疗后均得到解决。腓骨长肌腱可以被认为是关节镜下原发性单束 ACL 重建的一种安全、有效且有前途的移植物选择，因为它具有良好的功能结果和令人印象深刻的供踝功能。
