Evaluation of Ankle Complications after Peroneus Longus Tendon Harvesting for ACL Reconstruction.

Background: Anterior cruciate ligament (ACL) injuries are common and debilitating, often requiring surgical reconstruction. The peroneus longus tendon (PLT) is a promising autograft for ACL reconstruction, with less donor site morbidity than traditional grafts like bone-patellar tendon-bone and hamstring tendons. This study evaluates donor site ankle morbidity after PLT harvesting for ACL reconstruction. Materials and Methods: A retrospective observational study at an Indian Government Medical College and Hospital from February 2023 to October 2024 involved 56 patients with symptomatic ACL tears who underwent arthroscopic ACL reconstruction using PLT grafts. Donor site morbidity was assessed preoperatively and postoperatively using the visual analog scale for foot and ankle (VAS-FA) and American orthopaedic Foot and Ankle society (AOFAS) scores at 14 days, 4 weeks, 12 weeks, and 6 months. Data were analyzed with repeated measures analysis of variance. Results: Participants had a mean age of 36.8 years and an average injury duration of 13.3 months. Donor site morbidity occurred in 66.1% of patients, mainly as mild pain and swelling, which improved significantly over time. VAS-FA scores dropped from 7.52 preoperatively to 2.05 at 6 months, and AOFAS scores increased from 54.8 to 80.0. Chronic injury duration (over 16 months) was associated with poorer recovery, while preoperative pain, gender, graft size, and weight-bearing duration had no significant impact on recovery outcomes. Conclusion: PLT harvesting for ACL reconstruction leads to minimal donor site morbidity, with mild pain and swelling that improve over time. PLT grafts offer a promising alternative to traditional autografts, providing comparable outcomes and fewer complications. Larger studies with longer follow-up are needed to confirm these results.