To investigate the clinical efficacy of arthroscopic reconstruction of anterior cruciate ligament (ACL) with peroneus longus tendon (PLT) and study the donor-related complications.

A retrospective study was conducted on 45 patients who had anterior cruciate ligament rupture and treated in the Department of Joint Surgery of the Second Hospital of Tangshan between March and November 2017. The patients were divided into a PLT group (n=23) and an HT group (n=22). The patients in PLT group received the reconstruction of anterior cruciate ligament under arthroscope with autograft peroneus longus tendon, and the patients in HT group received arthroscopic reconstruction of anterior cruciate ligament with hamstring tendon single bundle. Preoperative Lachman test and front drawer test were positive on all patients together with rupture of anterior cruciate ligament showing on MRI. Side-to-side difference (SSD) and thigh circumference were taken before and after surgery. Knee and ankle functions were assessed by International Knee Documentation Committee(IKDC) score and foot and ankle disability index(FADI). Postoperative MRI scans were taken for assessment of tendon running.

All patients were included in postoperative follow-up for (17.3±1.4) months in average. No postoperative complication such as joint adhesion, ligament re-rupture or severe deep venous thrombosis of lower limb occurred. The diameter of PLT after graft weaving was found greater than that of HT, with statistically significant difference (t=-2.54, -10.523, both P<0.05). At 12 months after surgery, IKDC scores and activity of knee joint in two groups were remarkably improved in comparison with those before surgery (HT group t=-61.610 and PLT group t=-55.740, both P<0.05), and without statistically significant difference between the two groups (all P>0.05). There was no statistically significant difference in ankle FADI scores between the two groups (P>0.05). The bilateral difference of thigh circumference in the PLT group was smaller than that in the HT group (t=12.420, P<0.05). MRI indicated that the grafts were running well and without condylar fossa impingement in both groups.

Arthroscopic reconstruction of ACL with PLT autograft has good clinical effect, featuring less muscle atrophy of thigh and unaffected ankle function, which is worthy of clinical application.