Peroneus Longus Tendon Versus Hamstring Tendon Autograft for Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Studies.

Abstract

<h4>Background</h4>Anterior cruciate ligament reconstruction (ACLR) is a common orthopaedic procedure for which various graft options can be used. This systematic review and meta-analysis aimed to compare the efficacy of the peroneus longus tendon (PLT) and hamstring tendon (HT) autografts for primary ACLR.<h4>Hypothesis</h4>There would be no significant difference in patient outcomes between PLT and HT autografts in ACLR.<h4>Study design</h4>Systematic review; Level of evidence, 3.<h4>Methods</h4>Adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a thorough literature search was conducted on February 10, 2024, across the PubMed, Cochrane CENTRAL, and Scopus databases. The aim was to identify comparative studies investigating the effectiveness of PLT and HT autografts for primary ACLR. The initial literature search retrieved 96 studies. Ten studies met the eligibility criteria for inclusion. Data analysis was performed using RevMan Version 5.4.1. Functional scores, graft characteristics, donor site morbidity, and failure rates were compared.<h4>Results</h4>Ten studies involving 949 patients were included. Both the PLT and HT groups showed comparable functional outcomes, knee stability, and graft failure rates. PLT autografts demonstrated a larger mean graft diameter (8.63 mm vs 8.08 mm) and lower incidence of donor site morbidity (7.48% vs 22.01%) than HT autografts. There was a statistically significant mean difference (MD) favoring PLT autografts in the modified Cincinnati score (MD, 3.33; 95% CI, 1.84 to 4.81; <i>P</i> < .0001) and thigh circumference (MD, -7.62 mm; 95% CI, -8.90 to -6.33; <i>P</i> < .00001).<h4>Conclusion</h4>This review showed that both PLT and HT autografts are effective options for primary ACLR, with similar functional outcomes and knee stability. PLT autografts offer advantages in terms of graft diameter and donor site morbidity. Further research is warranted to confirm these findings and guide clinical decision-making in ACLR practice.