Mehran Soleymanha, Amirali Soleymani Nejad, Sohrab Keyhani, Fardis Vosoughi, Robert F LaPrade, Luke V Tollefson
{"title":"腓骨长肌腱收获用于前交叉韧带重建可获得良好的踝关节功能结果：系统回顾和荟萃分析。","authors":"Mehran Soleymanha, Amirali Soleymani Nejad, Sohrab Keyhani, Fardis Vosoughi, Robert F LaPrade, Luke V Tollefson","doi":"10.1002/ksa.70079","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The peroneus longus tendon (PLT) has emerged as a promising autograft option for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding donor-site morbidity and ankle functional outcomes. This systematic review and meta-analysis aimed to evaluate ankle performance following PLT harvest for ACL reconstruction.</p><p><strong>Methods: </strong>This systematic review and meta-analysis performed by searching five databases (PubMed, Embase, Web of Science, Scopus, and the Cochrane Library) up to March 2025. Inclusion criteria included: ACL reconstruction using PLT autograft, ≥6-month follow-up, and validated ankle outcomes (American Orthopaedic Foot And Ankle Society [AOFAS]/Foot and Ankle Disability Index [FADI] scores). Pooled effect sizes were calculated using random-effects models using R software (version 4.4.3). Heterogeneity was assessed via I² statistics, and risk of bias was evaluated using JBI checklists.</p><p><strong>Results: </strong>Twenty articles (1024 patients) were identified, comprising eleven prospective cohort studies and nine randomised clinical trials (RCT), based on title, abstract, and quality assessments. Meta-analysis demonstrated excellent postoperative ankle function, with pooled AOFAS scores of 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 similarly improved to 97.4 (96.0-98.9) by 6 months and 99.4 (98.7-100.1) at 24 months. Meta-regression revealed no significant association between age and AOFAS outcomes (β = -0.23, p = 0.36). Minor complications (e.g., transient hypaesthesia) occurred in 13%-23% of patients but resolved within months. No studies reported major nerve injuries or ankle instability.</p><p><strong>Conclusion: </strong>Peroneus longus tendon harvest for ACL reconstruction yields minimal donor-site morbidity, with consistently high AOFAS/FADI scores across all age groups. These findings support the safety of PLT autografts, though heterogeneity is evident, and the predominance of male participants and the regional focus of studies, mainly Asian populations, may affect generalisability.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Peroneus longus tendon harvest for ACL reconstruction yields good functional outcome of the ankle: A systematic review and meta-Analysis.\",\"authors\":\"Mehran Soleymanha, Amirali Soleymani Nejad, Sohrab Keyhani, Fardis Vosoughi, Robert F LaPrade, Luke V Tollefson\",\"doi\":\"10.1002/ksa.70079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The peroneus longus tendon (PLT) has emerged as a promising autograft option for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding donor-site morbidity and ankle functional outcomes. This systematic review and meta-analysis aimed to evaluate ankle performance following PLT harvest for ACL reconstruction.</p><p><strong>Methods: </strong>This systematic review and meta-analysis performed by searching five databases (PubMed, Embase, Web of Science, Scopus, and the Cochrane Library) up to March 2025. Inclusion criteria included: ACL reconstruction using PLT autograft, ≥6-month follow-up, and validated ankle outcomes (American Orthopaedic Foot And Ankle Society [AOFAS]/Foot and Ankle Disability Index [FADI] scores). Pooled effect sizes were calculated using random-effects models using R software (version 4.4.3). Heterogeneity was assessed via I² statistics, and risk of bias was evaluated using JBI checklists.</p><p><strong>Results: </strong>Twenty articles (1024 patients) were identified, comprising eleven prospective cohort studies and nine randomised clinical trials (RCT), based on title, abstract, and quality assessments. Meta-analysis demonstrated excellent postoperative ankle function, with pooled AOFAS scores of 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 similarly improved to 97.4 (96.0-98.9) by 6 months and 99.4 (98.7-100.1) at 24 months. Meta-regression revealed no significant association between age and AOFAS outcomes (β = -0.23, p = 0.36). Minor complications (e.g., transient hypaesthesia) occurred in 13%-23% of patients but resolved within months. No studies reported major nerve injuries or ankle instability.</p><p><strong>Conclusion: </strong>Peroneus longus tendon harvest for ACL reconstruction yields minimal donor-site morbidity, with consistently high AOFAS/FADI scores across all age groups. These findings support the safety of PLT autografts, though heterogeneity is evident, and the predominance of male participants and the regional focus of studies, mainly Asian populations, may affect generalisability.</p><p><strong>Level of evidence: </strong>Level II.</p>\",\"PeriodicalId\":520702,\"journal\":{\"name\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.70079\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/ksa.70079","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：腓骨长肌腱（PLT）已成为前交叉韧带（ACL）重建的一种有前途的自体移植物选择，但对供体部位发病率和踝关节功能结局的担忧仍然存在。本系统综述和荟萃分析旨在评估前交叉韧带重建后PLT收获的踝关节性能。方法：通过检索5个数据库（PubMed、Embase、Web of Science、Scopus和Cochrane Library）进行系统综述和荟萃分析，检索时间截止到2025年3月。纳入标准包括：使用PLT自体移植物重建ACL，随访≥6个月，验证踝关节结果（美国矫形足踝学会[AOFAS]/足踝残疾指数[FADI]评分）。使用R软件（4.4.3版），采用随机效应模型计算合并效应大小。通过I²统计量评估异质性，并使用JBI检查表评估偏倚风险。结果：根据标题、摘要和质量评估，纳入了20篇文章（1024例患者），包括11项前瞻性队列研究和9项随机临床试验（RCT）。meta分析显示术后踝关节功能良好，6个月时合计AOFAS评分为96.0(95%可信区间[CI]: 92.6-99.3)， 12个月时为96.1(93.9-98.2)，24个月时为97.2（93.9-100.6）。FADI评分同样在6个月时提高到97.4(96.0-98.9)，在24个月时提高到99.4（98.7-100.1）。meta回归显示年龄与AOFAS结果无显著相关性（β = -0.23, p = 0.36）。13%-23%的患者出现轻微并发症（如短暂性麻醉减退），但在几个月内消退。没有研究报告主要神经损伤或踝关节不稳定。结论：腓骨长肌腱摘取用于ACL重建的供体部位发病率最小，在所有年龄组中AOFAS/FADI评分始终较高。这些发现支持自体PLT移植的安全性，尽管异质性很明显，男性参与者的优势和研究的区域焦点（主要是亚洲人群）可能会影响普遍性。证据等级：二级。
Peroneus longus tendon harvest for ACL reconstruction yields good functional outcome of the ankle: A systematic review and meta-Analysis.
Purpose: The peroneus longus tendon (PLT) has emerged as a promising autograft option for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding donor-site morbidity and ankle functional outcomes. This systematic review and meta-analysis aimed to evaluate ankle performance following PLT harvest for ACL reconstruction.
Methods: This systematic review and meta-analysis performed by searching five databases (PubMed, Embase, Web of Science, Scopus, and the Cochrane Library) up to March 2025. Inclusion criteria included: ACL reconstruction using PLT autograft, ≥6-month follow-up, and validated ankle outcomes (American Orthopaedic Foot And Ankle Society [AOFAS]/Foot and Ankle Disability Index [FADI] scores). Pooled effect sizes were calculated using random-effects models using R software (version 4.4.3). Heterogeneity was assessed via I² statistics, and risk of bias was evaluated using JBI checklists.
Results: Twenty articles (1024 patients) were identified, comprising eleven prospective cohort studies and nine randomised clinical trials (RCT), based on title, abstract, and quality assessments. Meta-analysis demonstrated excellent postoperative ankle function, with pooled AOFAS scores of 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 similarly improved to 97.4 (96.0-98.9) by 6 months and 99.4 (98.7-100.1) at 24 months. Meta-regression revealed no significant association between age and AOFAS outcomes (β = -0.23, p = 0.36). Minor complications (e.g., transient hypaesthesia) occurred in 13%-23% of patients but resolved within months. No studies reported major nerve injuries or ankle instability.
Conclusion: Peroneus longus tendon harvest for ACL reconstruction yields minimal donor-site morbidity, with consistently high AOFAS/FADI scores across all age groups. These findings support the safety of PLT autografts, though heterogeneity is evident, and the predominance of male participants and the regional focus of studies, mainly Asian populations, may affect generalisability.
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