Ankle Function and Donor-Site Morbidity Following Peroneus Longus Graft Harvesting with or Without Tenodesis to Peroneus Brevis in Anterior Cruciate Ligament Reconstruction


Dogruoz F., Sari M. K., Ertan M. B., Ergun A., Gurcan S., KÖSE Ö.

Journal of Clinical Medicine, cilt.15, sa.7, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 7
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/jcm15072577
  • Dergi Adı: Journal of Clinical Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: anterior cruciate ligament reconstruction, peroneus longus tendon, tenodesis, donor site morbidity, ankle joint, radiography, flatfoot
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Background/Objectives: The peroneus longus tendon (PLT) is increasingly used as an autograft for anterior cruciate ligament reconstruction (ACLR). However, during PLT harvest, the necessity of distal peroneus longus-to-peroneus brevis (PL-to-PB) tenodesis for the potential preservation of donor ankle function and medial longitudinal arch alignment remains unclear. This study compared ankle function, donor-site morbidity, complications, and weight-bearing radiographic foot alignment after PLT harvest with and without distal tenodesis. Methods: Between January 2020 and December 2024, 92 primary ACLR cases using an ipsilateral PLT autograft were retrospectively screened; 60 patients with available bilateral weight-bearing comparative foot radiographs were included and categorized into a tenodesis group (n = 30) or a non-tenodesis group (n = 30). Ankle outcomes included American Orthopedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot and Foot and Ankle Disability Index (FADI) scores, ankle range of motion (ROM), and donor-site complications. Radiographic alignment was assessed using Meary’s angle and calcaneal pitch angle on bilateral weight-bearing lateral foot radiographs, including side-to-side differences. Results: Follow-up duration was comparable between groups (18.5 ± 4.4 vs. 16.8 ± 3.4 months, p = 0.113). No patient demonstrated clinically relevant loss of ankle range of motion or strength at final follow-up. AOFAS (97.3 ± 4.9 vs. 95.0 ± 5.5, p = 0.078) and FADI (96.8 ± 5.2 vs. 95.3 ± 5.5, p = 0.091) scores were similarly high in the tenodesis and non-tenodesis groups, respectively. Sural nerve sensory disturbance occurred in 6/30 (20.0%) versus 5/30 (16.7%) patients (p = 0.739), and no harvest-site infection was observed. On weight-bearing radiographs, Meary’s angle and calcaneal pitch angle did not differ significantly between groups on the operated side (Meary: 7.99 ± 6.76 vs. 4.76 ± 6.32°, p = 0.061; calcaneal pitch: 23.19 ± 5.94 vs. 21.41 ± 4.64°, p = 0.201) or intact side (Meary: 7.05 ± 6.89 vs. 5.36 ± 6.11°, p = 0.320; calcaneal pitch: 23.33 ± 5.43 vs. 22.00 ± 4.48°, p = 0.305). Side-to-side differences were small and comparable (Δ Meary: 0.94 ± 3.97 vs. −0.60 ± 3.58°, p = 0.120; Δ calcaneal pitch: −0.14 ± 3.35 vs. −0.59 ± 3.29°, p = 0.603). Conclusions: Distal PL-to-PB tenodesis did not appear to provide measurable advantages in donor-ankle patient-reported outcomes or weight-bearing radiographic foot alignment compared with no tenodesis after PLT harvest for ACLR.