Four-Strand Short Graft Failure Loads of Half–Peroneus Longus Tendon Grafts Compared With Full Semitendinosus Tendon Grafts

Background: Peroneus longus tendon (PLT) grafts are being more widely used in anterior cruciate ligament (ACL) reconstruction surgery, and recent literature has started to evaluate use of the anterior half of the PLT. A biomechanical study was performed to evaluate the load to failure of half-PLT and semitendinosus tendon (STT) grafts prepared in a short 4-strand graft format, in the same fashion as Tape Locking Screw (TLS) ACL reconstruction grafts. Hypothesis: Half-PLT grafts would be comparable to the STT grafts when used in a short 4-strand construct. Study Design: Controlled laboratory study, Methods: Semitendinosus and PLTs from both lower limbs of 7 fresh-frozen cadavers were harvested. Grafts were prepared in a 4-strand fashion, with a 55 mm–length graft, looped around TLS polyethylene terephthalate tape at the graft ends. An Instron 5567 machine was used, with grafts preloaded to 10 N and cycled 10 times up to 500 N, before measurement of load to failure. Results: The half-PLT grafts had a significantly decreased mean load to failure of 964.5 N compared with the STT graft mean of 1291 N ( P = .0001) in this study. Conclusion: Four-strand half-PLT grafts had a statistically significantly lower load to failure in this study compared with STT grafts. Surgeons may want to use caution if harvesting only the anterior half of the PLT or splitting the tendon into 2 grafts. Clinical Relevance: If a surgeon is considering using PLT for a 4-strand ACL graft, a full PLT graft is an acceptable alternative to an STT graft.