Ankle Eversion and First Ray Plantar Flexion Muscle Strength After Peroneus Longus Tendon Harvest for Anterior Cruciate Ligament Reconstruction

The peroneus longus tendon has been used for a graft in orthopedic reconstruction surgery due to its comparable biomechanical strength to the native Anterior Cruciate Ligament (ACL) and hamstring tendon. However, one of the considerations in choosing autograft is donor site morbidity. This study aimed to compare ankle eversion and first ray plantar flexion strength between donor site and its contralateral. HYPOTHESIS: The study hypothesis was that the eversion and first ray plantar flexion muscle strength were different between harvest site and contralateral healthy site. METHODS: From March 2017 to December 2018, patients who underwent ACL reconstruction using peroneus longus tendon autograft were included in this study. From the first day after surgery, the patients followed rehabilitation protocol. Ankle eversion and first ray plantar flexion strength were measured using a modifieddynamometer 6-months after surgery. Donor site morbidities were assessed 6 months after surgery using the Foot and Ankle Disability Index and American Orthopedic Foot and Ankle Society scoring system for ankle and hindfoot. RESULTS: Thirty-one patients fulfilled the inclusion criteria, with 22 males and 9 females, ranging from 18-45 years of age (mean: 27.58±8.69). There was no significant difference in ankle eversion strength at donor site compared to contralateral (p=0.54) with means 65.87±7.63 N and 66.96±8.38 N, respectively. Also, there was no significant difference in ankle first ray plantar flexion strength at donor site compared to contralateral (p=0.68) with means 150.64±11.67 N and 152.10±12.16 N, respectively. The FADI score of 99.71±0.57 and AOFAS score of 98.71±3.03 were considered excellent results. CONCLUSION: Our study shows that donor site ankle eversion and first ray plantar flexion strengths were similar with the contralateral healthy site with no donor site morbidity. This suggests that peroneus longus tendon is a promising graft in ACL reconstruction.