Early recovery and return to work after all-inside anterior cruciate ligament reconstruction using partial peroneus longus tendon autograft: A retrospective cohort study.

Abstract

PurposeTo compare early postoperative recovery, return to work (RTW), functional outcomes, and short-term knee stability after all-inside anterior cruciate ligament reconstruction (ACLR) using a partial peroneus longus tendon (PLT) autograft versus conventional hamstring tendon (HT) autograft reconstruction.MethodsThis retrospective cohort study included 80 patients who underwent primary ACLR between October 2022 and October 2023. Forty patients underwent all-inside ACLR using a partial PLT autograft, and 40 underwent conventional HT autograft ACLR. Minimum follow-up was 18 months. Patient-reported outcomes, range of motion, KT-2000 arthrometer side-to-side difference (SSD), clinical stability tests, early rehabilitation milestones, and RTW were evaluated during follow-up. RTW was defined as resumption of preinjury occupational duties without work restrictions.ResultsBoth groups showed postoperative improvement over time. Compared with the HT group, the PLT group achieved earlier out-of-bed mobilization, earlier assisted walking, and earlier RTW across occupational categories (all p < 0.001). The PLT group also had lower postoperative pain scores, greater range of motion, and higher Anterior Cruciate Ligament-Return to Sport after Injury scores during follow-up. Although Lysholm scores were higher in the HT group, International Knee Documentation Committee scores improved in both groups and postoperative Lachman and pivot-shift findings did not differ significantly. KT-2000 SSD was lower in the PLT group, but the final absolute difference was small.ConclusionAll-inside ACLR using a partial PLT autograft was associated with earlier postoperative mobilization and RTW than conventional HT autograft ACLR while maintaining comparable short-term clinical stability. Because graft type and surgical technique differed concurrently between groups, these findings should be interpreted as the combined effect of both factors rather than the isolated effect of graft choice alone.