Graft Dimensions and Clinical Outcomes Following Anterior Cruciate Ligament Reconstruction Using Hamstring Versus Peroneus Longus Autografts in Graft-Commensurate, Short-Statured Patients: A Prospective Observational Study.

Background Anterior cruciate ligament (ACL) reconstruction with hamstring tendon autografts is well-established, but peroneus longus autografts have emerged as a promising alternative. Optimal graft diameter is a prerequisite for knee stability and satisfactory postoperative outcomes. Attainable autograft diameter is shown to directly correlate with patient height. The relative efficacy of hamstring (HS-R) versus peroneus longus (PL-R) reconstruction for ACL tears among graft-commensurate, short-statured patients is unknown. Methodology In this prospective observational study, 44 patients with a height of 173 cm or less who underwent arthroscopic single-bundle anterior cruciate ligament reconstruction using quadrupled HS-R or tripled PL-R for isolated ACL tears were followed for a minimum of 12 months postoperatively. Patient groups were compared in terms of their demographic and anthropometric characteristics, mode and side of injury, preoperative clinical assessment findings, autograft dimensions attained, and postoperative clinical assessment findings. Donor site morbidity and postoperative complications, where present, were recorded. Results The study cohort comprised 22 men each, who underwent HS-R and PL-R. The patient groups were comparable in terms of age, height, weight, body mass index, mode and side of injury, and preoperative International Knee Documentation Committee (IKDC), Lysholm, and Modified Cincinnati Score (MCS). PL-R was associated with significantly longer grafts (median (interquartile range (IQR)): 90 (89.5-90) mm vs. 90 (80-90) mm;