A prospective study on functional outcome at donor site following peroneus longus graft harvest for knee ligament reconstruction in a tertiary care hospital in South India

Background: Knee ligament reconstruction is widely performed worldwide, and graft choice for the same has always been an area of research. Currently, the most preferred grafts include the bone-patellar tendon-bone graft (BPTB) and the hamstring graft. However, there are some significant donor site morbidities associated with these grafts. Therefore, we utilized the peroneus longus tendon (PLT) graft, which has demonstrated functional outcomes comparable to the hamstring graft, and assessed the associated donor site functional outcomes. Materials and Methods: Patients who required a knee ligament reconstruction were selected and PLT was harvested as the graft. The patients were followed up for 12 months postoperatively. Functional scoring was done with the American Orthopedic Foot and Ankle Society Ankle and Hindfoot (AOFAS-AH) scoring and Visual Analog Scale-foot and ankle (VAS-FA) were used. Furthermore, the power of foot eversion and plantar flexion was tested and recorded clinically by Medical Research Council grading. Results: Thirty patients fulfilled the inclusion criteria (22 male and 8 female patients). Follow-up period was 12 months. The mean pre- and postoperative AOFAS-AH score was 99.27 ± 0.94 and 99.13 ± 1.01, respectively, at 12 months follow-up. The mean pre- and postoperative VAS-FA score was 98.53 ± 1.38 and 98.00 ± 1.34, respectively, at 12 months follow-up (P > 0.05). The 12 months postoperative power of eversion and plantar flexion were grade 5 in all patients. Conclusion: There was no significant difference in functional outcome and muscle power was noted postoperatively (at 1-year follow-up) at the donor site following PLT graft harvest. No significant difference in functional outcome was observed, and muscle power was preserved postoperatively (at 1-year follow-up) at the donor site following PLT graft harvest. Thus, we conclude that PLT can be used safely as a graft for ligament reconstruction with no significant donor site morbidities.