Peroneous Longus Tendon Versus Hamstring Tendon Autograft On Anterior Cruciate Ligament Reconstruction: A Meta-Analysis and Systematic Review

INTRODUCTION: Anterior Cruciate Ligament (ACL) injury is one of the most common knee injuries. ACL reconstruction is the current gold standard to restore functional of the knee. Graft selection is important for satisfactory outcomes. Currently, most used autograft are hamstring tendon (HT) and bone patellar tendon bone (BPTB) grafts. This study aims to thoroughly evaluate and review an alternative autograft for ACL reconstruction, which is peroneus longus tendon (PLT). METHOD: Systematic review and meta-analysis was conducted using PRISMA guidelines. Literature was searched through PubMed, Google Scholar, Science Direct and Cochrane Library using Boolean operators. This study included original articles reporting on (1) clinical studies of ACL reconstruction (single-bundle or double-bundle) using PLT autograft (anterior-half, posterior half, or full-thickness); and (2) studies directly comparing outcomes of PLT versus HT. All procedures were primary ligament reconstructions performed for symptomatic acute or chronic ACL injury, with or without meniscal injury. The outcomes assessed included clinical and functional outcome, namely IKDC score, AOFAS scale and FADI. RESULTS: From 247 studies obtained, after full-text review, 4 studies met all eligibility criteria. A total of 259 patients were included in this study. No significant differences was found in IKDC score (p = 0.99) and FADI score (p = 0.11) but significant differences was found in the mean of AOFAS score in favor of HT autograft (p = 0.03). CONCLUSION: PLT autograft is a suitable alternative graft choice from the others for the knee of patients undergoing ACL reconstruction.