Ipsilateral Autologous Peroneus Longus and Bone Patellar Tendon Graft for Revision Anterior Cruciate Ligament Reconstruction Leads to Similar Functional Outcome.

Abstract

Introduction: Due to the yearly rise in primary anterior cruciate ligament (ACL) reconstructions, revision ACL reconstruction is becoming more and more common in knee surgery. Choosing the appropriate graft and determining the surgical treatment staging by assessing the likelihood of doing the most anatomical revision canals and placing them with the primary canals before surgery are crucial factors affecting treatment outcomes.

Aim of the study: The purpose of this study was to evaluate the differences in the patient-reported functional outcomes in revision ACL reconstruction using peroneus longus and bone-patellar tendon-bone (BTB) autografts in a single-stage revision ACL reconstruction.

Materials and methods: Twenty-three patients who were eligible for follow-up among 25 surgeries performed between 2015 and 2023 were included in this retrospective analysis and met the inclusion criteria. The patient reported functional outcome, Lysholm knee score, Tegner activity level, and Visual Analog Scale (VAS) for pain before the injury and during the most recent follow-up. The peroneus longus (PL) and bone-patellar tendon-bone (BPTB) groups' patient-reported results were assessed.

Results: There were no significant differences between the two revision groups with PL and BPTB autograft in terms of age, sex, duration between injury and surgery, concurrent injuries, and isolated or complex surgeries. There was not a significant difference between the groups' pre-injury patient-reported outcomes, including the Lysholm knee score, Tegner activity, and VAS for pain (n.s.). There was not a significant difference in the two groups' functional results at follow-up, although both groups' functional outcomes improved and all patients recovered to their pre-injury activity level.

Conclusion: Overall, the findings suggest that graft options (peroneus longus and BTB) and surgical complexities (isolated and complex revision) yield comparable functional outcomes for most measures. However, notable differences in post-operative pain levels warrant further exploration. These results underscore the effectiveness of both graft types and surgical techniques in achieving satisfactory recovery while acknowledging the necessity of customized approaches to pain management based on individual patient circumstances.