Long-Term Clinical Outcomes Following Anterior Cruciate Ligament Reconstruction Using Peroneus Longus Allograft: A 10-Year Case Series
1Department of Orthopedics and Traumatology, Medipol University, Istanbul, Türkiye
2Department of Orthopedics and Traumatology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
Eur Arch Med Res 2025; 41(2): 69-74 DOI: 10.14744/eamr.2025.25582
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Abstract

Objective: The aim of this study was to assess the long-term stability, functional outcomes, and patient satisfaction following anterior cruciate ligament (ACL) reconstruction using peroneus longus tendon allograft over a 10-year period.
Materials and
Methods: This retrospective case series included 20 patients who underwent arthroscopic ACL reconstruction with a peroneus longus tendon allograft between August 2012 and September 2014. Clinical and functional outcomes were evaluated using Lysholm and Modified Cincinnati scores, Lachman and Pivot-Shift tests, KT-1000 arthrometer, and Cybex II isokinetic dynamometry. In addition, complication rates, graft failure, and long-term knee function were assessed.

Results: The mean follow-up duration was 10.3±1.5 years. The Lysholm score at the final follow-up was 98.65±3.32, with 95% of patients classified as having an excellent outcome. The Modified Cincinnati score was 29.45±1.14. Knee stability assessments showed that 60% of patients had a negative Lachman test, while 35% had a Grade 1 positive result and 5% had a Grade 2 positive result. The Pivot-Shift test was negative in 75% of patients, while 25% had a Grade 1 positive result. KT-1000 arthrometer measurements demonstrated slight differences in anterior tibial translation between the operated and contralateral knee. Muscle strength loss between the operated and non-operated limbs remained clinically insignificant. One patient (5%) experienced mild flexion restriction (<10° loss), and transient knee hypoesthesia was observed in 9 patients (45%) but resolved without intervention. No graft failure, re-rupture, immune response, or infections occurred during the 10-year follow-up.

Conclusion: Peroneus longus tendon allograft demonstrated excellent long-term clinical and functional outcomes with a low complication rate. It appears to be a viable alternative to autografts, especially for patients seeking to avoid donor site morbidity. Larger comparative studies are required to confirm these findings and assess long-term graft durability.