Vol. 11, Issue 3 (2025)

Background: Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure for knee injuries, with autografts such as hamstring tendon and peroneus longus tendon being frequently used. This study aims to compare the functional outcomes and donor site morbidity of these two grafts to identify the better option for ACL reconstruction.

Objective: To assess and compare the functional outcomes and donor site morbidity of peroneus longus tendon versus hamstring tendon grafts in arthroscopic ACL reconstruction.

Methods: This prospective cohort study included 32 participants diagnosed with isolated ACL tears who underwent arthroscopic ACL reconstruction using either a hamstring tendon or peroneus longus tendon graft. Participants were randomly assigned to one of the two graft groups, with 16 in each. Functional outcomes were assessed preoperatively and at 4 and 12 weeks postoperatively using the International Knee Documentation Committee (IKDC) and Lysholm scores. Donor site morbidity was assessed qualitatively. Statistical analyses were conducted using chi-square tests for demographic factors and t-tests for functional outcomes, with p-values <0.05 considered significant.

Results: Preoperative IKDC and Lysholm scores were significantly higher in the peroneus longus group (43.84±4.73, 32.20±6.08) compared to the hamstring group (41.60±6.09, 25.96±3.79; p < 0.05). At 4 weeks postoperatively, peroneus longus group showed superior IKDC (61.46±6.22 vs. 57.63±4.28; p = 0.022) and Lysholm scores (50.63±5.64 vs. 48.19±6.03; p = 0.049). By 12 weeks, functional outcomes were slightly outperforming with the peroneus longus group in IKDC (80.15±5.32 vs. 75.52±4.46; p = 0.047) and Lysholm scores (69.96±4.98 vs. 69.49±5.79; p = 0.024). Donor site morbidity was minimal for both grafts, with no severe complications reported.

Conclusion: In conclusion, both hamstring tendon and peroneus longus tendon grafts showed favorable functional outcomes in ACL reconstruction, with peroneus longus tendon grafts demonstrating slightly superior results at 4 and 12 weeks postoperatively. Donor site morbidity was minimal for both graft types, suggesting that either graft can be a viable option depending on patient-specific factors.