SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Peroneus longus tendon harvest for ACL reconstruction yields good functional outcome of the ankle: A systematic review and meta-analysis.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Comparative biomechanical strength of autografts for ligament reconstruction: quadriceps, rectus femoris, peroneus longus, patellar, hamstring configurations (quadruple and braided) and iliotibial band: an exploratory cadaveric biomechanical study.BMC musculoskeletal disorders · 2026Article
- Clinical and Donor-site Outcomes of Full-thickness Peroneus Longus Autograft in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Prospective Indian Cohort Study.Journal of orthopaedic case reports · 2026Article
- Letter to Editor: Comparative Evaluation of Peroneus Longus Tendon and Hamstring Tendon Autografts in Primary Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.Journal of orthopaedic case reports · 2026Article
- Potentially impaired dynamic ankle control despite increased eversion and first-ray plantarflexion strength after peroneus longus tendon harvest for anterior cruciate ligament reconstruction: an observational study.International orthopaedics · 2026Observational
- Ankle Function and Donor-Site Morbidity Following Peroneus Longus Graft Harvesting with or Without Tenodesis to Peroneus Brevis in Anterior Cruciate Ligament Reconstruction.Journal of clinical medicine · 2026Article
- Sport-Specific Considerations in ACL Reconstruction: Diagnostic Evaluation and Graft Selection.Diagnostics (Basel, Switzerland) · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
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Abstract
purposeThe 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.
methodsThis 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.
resultsTwenty 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.
conclusionPeroneus 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. LEVEL OF EVIDENCE: Level II.
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