Comparison of Functional Outcome of Arthroscopic Acl Reconstruction Using Hamstring Graft vs Peroneus Longus Tendon Autograft

Background: Anterior cruciate ligament (ACL) reconstruction is a standard orthopedic procedure, with hamstring tendon autografts (HT) traditionally serving as the preferred graft choice. Recently, the peroneus longus tendon (PLT) has emerged as a promising alternative due to comparable biomechanical strength and minimal donor-site morbidity. Objective: To compare the functional outcomes of arthroscopic ACL reconstruction using hamstring tendon autograft versus peroneus longus tendon autograft. Study Design: Comparative prospective study. Setting: Department of Orthopedic Surgery, Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: From August 2024 to July 2025. Methods: A total of 60 patients with ACL tears were enrolled and equally divided into two groups. Group A underwent ACL reconstruction using an ipsilateral hamstring tendon autograft, while Group B received an ipsilateral peroneus longus tendon autograft. All patients followed a standardized postoperative rehabilitation protocol. Functional outcomes were evaluated using the International Knee Documentation Committee (IKDC) score and the Modified Cincinnati Score (MCS), assessed preoperatively and at six months postoperatively. Statistical analysis was performed using SPSS version 25, with p < 0.05 considered significant. Results: The mean age was 28.87 ± 6.75 years in Group A and 28.07 ± 6.11 years in Group B. Males constituted 90.0% in Group A and 83.3% in Group B. At the six-month follow-up, both groups demonstrated significant improvement in functional outcomes. The mean postoperative IKDC scores were 83.27 ± 3.79 (Group A) and 84.83 ± 3.07 (Group B), while mean MCS values were 85.33 ± 2.46 and 86.17 ± 1.96, respectively. No statistically significant difference was observed between the two groups (p > 0.05). Conclusion: Arthroscopic ACL reconstruction using either hamstring or peroneus longus tendon autografts provides excellent and comparable functional outcomes. Although the peroneus longus tendon group showed slightly higher IKDC and MCS scores, the difference was not statistically significant, supporting its use as a viable alternative graft source.