Functional Outcome in Arthroscopic Anterior Cruciate Ligament Reconstruction Using an Autologous Quadrupled Hamstring Tendon Versus Peroneus Longus Tendon Graft: A Comparative Study
5 affiliations
- 1Department of Orthopaedics, MM College of Medical Sciences and Research, Ambala, Haryana, India.
- 2Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India.
- 3Department of Orthopaedics, Fortis Memorial Research Institute, Gurugram, Haryana, India.
- 4Department of Orthopaedics, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India.
- 5Department of Orthopaedics, Artemis Hospital, Gurugram, Haryana, India.
Abstract
Background: The knee is the largest and most complex synovial hinge joint, stabilized by primary ligaments (anterior cruciate ligament [ACL], posterior cruciate ligament, medial collateral ligament, lateral collateral ligament) and secondary structures, such as the hamstrings and quadriceps. The ACL is vital for preventing anterior tibial translation and maintaining rotational stability. Aim of the Study: (1) To perform arthroscopic ACL reconstruction using autologous quadrupled Hamstring Tendon (HT) or peroneus longus tendon (PLT) grafts. (2) To compare the functional outcomes of ACL reconstruction with these two grafts. Materials and Methods: This study was conducted at the Department of Orthopedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, over 24 months and included 30 patients aged 18–45 years with symptomatic ACL insufficiency confirmed clinically and through magnetic resonance imaging. Patients with additional ligament injuries, osteoarthritis, or systemic conditions were excluded. Participants were randomized into two groups for arthroscopic ACL reconstruction with either a hamstring or PLT graft. Surgical procedures included femoral and tibial tunnel creation and graft fixation with adjustable loop endobuttons and bioabsorbable screws. Post-operative care included immobilization, antibiotics, structured rehabilitation, and follow-up assessments at 2, 12, and 24 weeks. Functional outcomes were assessed using International Knee Documentation Committee (IKDC) scores, while donor site morbidity was evaluated using American Orthopaedic Foot and Ankle Society scores. Data were analyzed with the Statistical Package for the Social Sciences v26 using Chi-square tests, t-tests, and repeated measures Analysis of Variance; significance was set at P < 0.05. Results: Both groups were demographically similar (60% males; mean age 32 years). Sports-related trauma was the most common cause of ACL injury. Group B (peroneus longus) had significantly larger graft diameters and lengths (P < 0.01). No surgical site infections occurred. Group A initially showed more graft-site paresthesia, which resolved by 24 weeks, while Group B experienced a temporary reduction in ankle eversion strength at 12 weeks, which normalized by 24 weeks. Functional outcomes, including IKDC scores and range of motion, were comparable between groups at 12 and 24 weeks. Conclusion: Arthroscopic ACL reconstruction using either hamstring or peroneus longus grafts results in similar clinical and functional outcomes at 6 months. The peroneus longus graft, despite a temporary impact on ankle eversion, is an effective and viable alternative to the HT graft.
Related
- A Comparative Study of Functional Outcomes Following Arthroscopic Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon versus Peroneus Longus Tendon Autograft
- Functional Assessment of Hybrid Superior Capsular Reconstruction Technique by Combination of Autologous Fascia Lata and Long Head of Biceps Tendon in Cases with Irreparable Rotator Cuff Tears - Case Series.
- A Study of Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using Hamstring Graft.
- Biological Augmentation of Arthroscopic Partial‐Thickness Bursal‐Sided Rotator Cuff Repair Using Minced Autologous Glenohumeral Ligament Tissue Particles
- Biomechanical Study of the Quadrupled Gracilis Tendon Graft for the Anterior Cruciate Ligament Reconstruction
BibTeX
@article{singh2026functional,
title = {{Functional Outcome in Arthroscopic Anterior Cruciate Ligament Reconstruction Using an Autologous Quadrupled Hamstring Tendon Versus Peroneus Longus Tendon Graft: A Comparative Study}},
author = {Abhishek Singh and Gagandeep Gupta and Samay Das and Akhilesh Saini and Ayush Singh and Nikhil Relwani},
journal = {Journal of Orthopaedic Case Reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8550},
url = {https://doi.org/10.13107/jocr.2026.v16.i11.8550},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Functional Outcome in Arthroscopic Anterior Cruciate Ligament Reconstruction Using an Autologous Quadrupled Hamstring Tendon Versus Peroneus Longus Tendon Graft: A Comparative Study
AU - Abhishek Singh
AU - Gagandeep Gupta
AU - Samay Das
AU - Akhilesh Saini
AU - Ayush Singh
AU - Nikhil Relwani
PY - 2026
DA - 2026/11/01
JO - Journal of Orthopaedic Case Reports
DO - 10.13107/jocr.2026.v16.i11.8550
UR - https://doi.org/10.13107/jocr.2026.v16.i11.8550
AB - Background: The knee is the largest and most complex synovial hinge joint, stabilized by primary ligaments (anterior cruciate ligament [ACL], posterior cruciate ligament, medial collateral ligament, lateral collateral ligament) and secondary structures, such as the hamstrings and quadriceps. The ACL is vital for preventing anterior tibial translation and maintaining rotational stability. Aim of the Study: (1) To perform arthroscopic ACL reconstruction using autologous quadrupled Hamstring Tendon (HT) or peroneus longus tendon (PLT) grafts. (2) To compare the functional outcomes of ACL reconstruction with these two grafts. Materials and Methods: This study was conducted at the Department of Orthopedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, over 24 months and included 30 patients aged 18–45 years with symptomatic ACL insufficiency confirmed clinically and through magnetic resonance imaging. Patients with additional ligament injuries, osteoarthritis, or systemic conditions were excluded. Participants were randomized into two groups for arthroscopic ACL reconstruction with either a hamstring or PLT graft. Surgical procedures included femoral and tibial tunnel creation and graft fixation with adjustable loop endobuttons and bioabsorbable screws. Post-operative care included immobilization, antibiotics, structured rehabilitation, and follow-up assessments at 2, 12, and 24 weeks. Functional outcomes were assessed using International Knee Documentation Committee (IKDC) scores, while donor site morbidity was evaluated using American Orthopaedic Foot and Ankle Society scores. Data were analyzed with the Statistical Package for the Social Sciences v26 using Chi-square tests, t-tests, and repeated measures Analysis of Variance; significance was set at P < 0.05. Results: Both groups were demographically similar (60% males; mean age 32 years). Sports-related trauma was the most common cause of ACL injury. Group B (peroneus longus) had significantly larger graft diameters and lengths (P < 0.01). No surgical site infections occurred. Group A initially showed more graft-site paresthesia, which resolved by 24 weeks, while Group B experienced a temporary reduction in ankle eversion strength at 12 weeks, which normalized by 24 weeks. Functional outcomes, including IKDC scores and range of motion, were comparable between groups at 12 and 24 weeks. Conclusion: Arthroscopic ACL reconstruction using either hamstring or peroneus longus grafts results in similar clinical and functional outcomes at 6 months. The peroneus longus graft, despite a temporary impact on ankle eversion, is an effective and viable alternative to the HT graft.
SN - 2250-0685
SN - 2321-3817
ER -