Can we use peroneus longus in addition to hamstring tendons for anterior cruciate ligament reconstruction?

Authors

1 Department of Orthopedics, School of Medicine, Isfahan, Iran

2 General Physician, School of Medicine, Isfahan, Iran

3 Department of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The aim of this study is to evaluate the possible effects of removing the peroneus longus on the ankle and gait parameters, in order to add insufficient hamstring tendons for anterior cruciate ligament (ACL) reconstruction.
Materials and Methods: In this controlled clinical trial, 375 patients with ACL rupture who underwent ACL reconstruction arthroscopically using hamstring tendons in the orthopedic clinics of Isfahan University of Medical Sciences in 2010 and 2011 were selected. Fifteen patients were included because their hamstring tendon diameter was lower than 8 mm and peroneus longus was added. After 6 months, the patients were followed using "Kistler force plate" to detect 3D kinematics and kinetics of the ankles and spatiotemporal walking parameters.
Results: There was a significant difference between both operated and non-operated ankles in flexion/extension range of motion (P < 0.05). There was no significant difference between the moments of both ankles in sagittal and coronal planes (P > 0.05), but there was a significant difference between the moments of both ankles in the transverse plane (P = 0.006). There was a significant difference in the force of operated and non-operated ankles in all three planes (P < 0.05). There was no significant difference in the mean values of spatiotemporal gait parameters between operated and non-operated sides (P > 0.05).
Conclusion: Removing the peroneus longus tendon has no effect on gait parameters and does not lead to instability of the ankle. So, it can be used as an autogenous graft in orthopedic surgeries.

Keywords

1. Marimuthu K, Joshi N, Sharma M, Sharma CS, Bhargava R, Rajawat AS, et al. Anterior cruciate ligament reconstruction using the medial third of the patellar tendon. J Orthop Surg 2011;19:221-5.  Back to cited text no. 1
    
2. Edgar CM, Zimmer S, Kakar S, Jones H, Schepsis AA. Prospective Comparison of Auto and Allograft Hamstring Tendon Constructs for ACL Reconstruction. Clin Orthop Relat Res 2008;466:2238-46.  Back to cited text no. 2
    
3. Gohil S, Annear PO, Breidahl W. Anterior cruciate ligament reconstruction using autologous double hamstrings: a comparison of standard versus minimal debridement techniques using MRI to assess revascularisation. A randomised prospective study with a one- year follow-up. J Bone Joint Surg Br 2007;89:1165-71.  Back to cited text no. 3
    
4. Kerimoglu S, Aynaci O, Saracoglu M, Aydin H, Turhan AU. Anterior cruciate ligament reconstruction with the peroneus longus tendon. Acta Orthop Traumatol Turc 2008;42:38-43.  Back to cited text no. 4
    
5. Marrale J, Morrissey MC. Haddad FS. A literature review of autograft and allograft anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2007;15:690-704.  Back to cited text no. 5
    
6. Zhao J, Huangfu X. The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft source. Am J Sports Med 2012;40:662-71.  Back to cited text no. 6
    
7. de Jong SN, van Caspel DR, van Haeff MJ, Saris DB. Functional assessment and muscle strength before and after reconstruction of chronic anterior cruciate ligament lesions. Arthroscopy 2007;23:21-8.  Back to cited text no. 7
    
8. Moisala AS, Jarvela T, Kannus P, Jarvinen M. Muscle strength evaluations after ACL reconstruction. Int J Sports Med 2007;28:868-72.  Back to cited text no. 8
    
9. Meier WA, Marcus RL, Dibble LE, Foreman KB, Peters CL, Mizner RL, et al. The long-term contribution of muscle activation and muscle size to quadriceps weakness following total knee arthroplasty. J Geriatr Phys Ther 2009;32:35-8.  Back to cited text no. 9
    
10. Keays SL, Bullock-Saxton JE, Keays AC, Newcombe PA, Bullock MI. A 6-year follow-up of the effect of graft site on strength, stability, range of motion, function, and joint degeneration after anterior cruciate ligament reconstruction: Patellar tendon versus semitendinosus and Gracilis tendon graft. Am J Sports Med 2007;35:729-39.  Back to cited text no. 10
    
11. Karanikas K, Arampatzis A, Bruggemann GP. Motor task and muscle strength followed different adaptation patterns after anterior cruciate ligament reconstruction. Eur J Phys Rehabil Med 2009;45:37-45.  Back to cited text no. 11
    
12. Williams GN, Snyder-Mackler L, Barrance PJ, Buchanan TS. Quadriceps femoris muscle morphology and function after ACL injury: A differential response in copers versus non-copers. J Biomech 2005;38:685-93.  Back to cited text no. 12
    
13. Vairo GL, Myers JB, Sell TC, Fu FH, Harner CD, Lephart SM. Neuromuscular and biomechanical landing performance subsequent to ipsilateral semitendinosus and gracilis autograft anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2008;16:2-14.  Back to cited text no. 13
    
14. Takeda Y, Kashiwaguchi S, Matsuura T, Higashida T, Minato A. Hamstring muscle function after tendon harvest for anterior cruciate ligament reconstruction: Evaluation with T2 relaxation time of magnetic resonance imaging. Am J Sports Med 2006;34:281-8.  Back to cited text no. 14
    
15. Thomas AC. Muscle Dysfunction associated with ACL injury and reconstruction. Michigan (USA): University of Michigan; 2010. p. 235.  Back to cited text no. 15