Outcome of ankle joint function after anterior cruciate ligament reconstruction using peroneus longus graft.

Abstract

Objective: To evaluate the outcome of ankle joint function after anterior cruciate ligament (ACL) reconstruction using the peroneus longus tendon (PLT) autograft. Study Design: Prospective Longitudinal study. Setting: Department of Orthopedic Surgery, Madinah Teaching Hospital, Faisalabad. Period: 19^th July 2025 to 1^st Feb 2026. Methods: Arthroscopic repair utilizing ipsilateral PLT autograft was performed on 96 patients, ranging in age from 18 to 50 years, who had a verified ACL rupture. The American Orthopedic Foot and Ankle Society (AOFAS) score was used to evaluate ankle function before and after surgery at 3,6, and 12 weeks. Statistical analysis was carried out using repeated measures ANOVA to analyze changes over time, based on demographic and clinical data. To account for any confounding factors such as age, gender, BMI, involved side, comorbidities, and injury mechanism, stratification was used. Results: The mean AOFAS scores increased progressively from 64.35 ± 4.14 at 3 weeks to 73.35 ± 3.13 at 6 weeks and 81.75 ± 3.71 at 12 weeks, indicating significant improvement in ankle function (p < 0.001). Excellent and good functional outcomes were achieved in 92.7% of patients, with fair outcomes in 7.3%. Donor-site complications were minimal, with preserved eversion and plantarflexion strength in the majority of patients. No patient reported ankle instability, gait disturbance, or limitations in daily or sports activities. Functional outcomes were significantly associated with age, BMI, gender, and mode of injury, while side of knee involvement had no effect. Conclusion: ACL reconstruction using the peroneus longus tendon autograft provides excellent knee stability while preserving ankle joint function. The procedure is safe, effective, and associated with minimal donor-site morbidity, making PLT a reliable graft option for ACL reconstruction.