Evaluation of ankle and foot functions after peroneus longus harvesting in anterior cruciate reconstruction: a prospective clinical study

Background
Anterior cruciate ligament (ACL) injury is one of the most common knee injuries; with an estimated 200,000 injuries in the United States annually. ACL reconstruction is the gold standard for restoring knee stability to reduce the risk of secondary meniscal tears and symptomatic osteoarthritis. It requires either an autograft, allograft or artificial graft.


Objective
To evaluate the ankle and foot functions after harvesting in ACL reconstruction (ACLR).


Patients and methods
This prospective clinical study included 20 patients who underwent ACLR using the peroneus longus tendon as an autograft. American Orthopedic Foot and Ankle Society (AOFAS) score was used to assess the function of the foot and ankle after harvesting the peroneus longus tendon. The normal and the donor sides were compared.


Results
Three months postoperatively, the mean AOFAS score on the normal side was 100±0, while on the donor side, it ranged from 90 to 96 with a mean of 91.1±0.78 (highly statistically significant difference at P<0.001). At the same time, the mean dorsiflexion and plantar flexion on the normal side were 17.65±1.89 and 47.7±2.38, respectively. In contrast, on the donor side, the mean was 13.05±1.50 and 43.4±2.34 (highly statistically significant difference at P<0.001). At the 6-month follow-up examination, the mean AOFAS score on the normal side was 100±0, while on the donor side, it ranged from 98 to 100 with a mean of 99.7±0.95. (No statistically significant difference at P<0.001). Also, the mean dorsiflexion and plantar flexion on the donor side were 17.4±1.63 and 47.3±2.34, respectively, with no statistically significant difference.


Conclusion
There was a statistically significant difference in the functional outcomes between the donor and the normal sides three months postoperatively. However, at a 6-month follow-up, both the donor and the normal side had nearly the same functional outcomes.