Peroneus longus tendon harvest for ACL reconstruction yields good functional outcome of the ankle: A systematic review and meta-analysis.
Mehran Soleymanha, Amirali Soleymani Nejad, Sohrab Keyhani et al.
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In 30 seconds
This systematic review and meta-analysis assessed ankle function and donor-site morbidity after peroneus longus tendon harvest for ACL reconstruction. It included 20 studies involving 1024 patients: eleven prospective cohort studies and nine randomised clinical trials. Pooled AOFAS scores were 96.0 (95% confidence interval [CI]: 92.6-99.3) at 6 months, 96.1 (93.9-98.2) at 12 months, and 97.2 (93.9-100.6) at 24 months. FADI scores were also high. Minor complications occurred in 13%-23% of patients and resolved within months; no major nerve injuries or ankle instability were reported.
Key findings
- Pooled AOFAS scores were 96.0 (95% confidence interval [CI]: 92.6-99.3) at 6 months and 97.2 (93.9-100.6) at 24 months.
- FADI scores reached 97.4 (96.0-98.9) by 6 months and 99.4 (98.7-100.1) at 24 months.
- Minor complications, including transient hypaesthesia, occurred in 13%-23% of patients and resolved within months.
- No included studies reported major nerve injuries or ankle instability.
Why it matters
Ankle donor-site function is an important consideration when selecting an autograft for ACL reconstruction. Across the included studies, ankle outcome scores remained high through 24 months, while reported complications were minor and transient. These findings help characterise the potential donor-site trade-off, although the review notes heterogeneity and limited generalisability.
What to keep in mind
The review reports heterogeneity, a predominance of male participants, and a regional focus, mainly in Asian populations, which may limit generalisability.