腓骨长肌腱与腘绳肌腱自体移植物在ACL重建中的比较：移植物直径与供区并发症分析
简介
本研究回顾性比较了腓骨长肌与腘绳肌腱自体移植物在ACL重建中的临床效果。共纳入30例患者，各15例：腘绳肌腱组初始制备为4股，若术中直径<7.5 mm则增至6股；腓骨长肌组制备为2股。所有手术由同一高年资医师完成，固定方案及康复流程一致。至少2年随访显示，两组Lysholm、IKDC评分及膝关节稳定性无显著差异（P>0.05）。腓骨长肌初始直径（平均8.71…
英文摘要
BACKGROUND: Surgeons increasingly consider the peroneus longus tendon an effective alternative to hamstring autografts for anterior cruciate ligament reconstruction (ACLR). Choosing the right graft critically impacts long-term knee stability, prompting surgeons to strictly avoid undersized tissues. This study retrospectively compared clinical outcomes, knee stability, and comprehensive donor-site morbidity in ACLR utilizing peroneus longus versus hamstring tendon autografts. METHODS: We evaluated 30 patients undergoing arthroscopic ACLR in this retrospective review. The cohort was divided equally into hamstring tendon group (n=15), initially prepared as 4-strand constructs and augmented to 6 strands when intraoperative sizing fell below 7.5 mm and a peroneus longus graft group (n=15), prepared as 2-strand constructs. One senior surgeon applied the identical surgical technique, fixation method, and postoperative protocol across both groups. We assessed functional outcomes (Lysholm and IKDC scores) at a minimum 2-year follow-up and measured graft diameters intraoperatively. To evaluate donor-site morbidities, we recorded thigh circumference, AOFAS scores, FADI scores, and ankle range of motion (ROM). RESULTS: All 30 patients completed at least two years of follow-up (range 24-31 months). Statistically, the two cohorts showed comparable clinical outcomes and overall knee stability (P > 0.05). Initial peroneus longus diameter (mean 8.71 mm) exceeded initial hamstring diameter (mean 7.65 mm) (P<0.001); 6 cases augmented to 6 strands reached a final mean of 8.2 mm. Furthermore, ankle assessments (AOFAS, FADI, and ROM) revealed no joint dysfunction or sports restrictions in the peroneus longus patients. CONCLUSION: Peroneus longus patients experienced less anteromedial knee pain and notably less thigh hypotrophy than the hamstring group. Given its larger structural diameter and comparable short-term clinical outcomes, the peroneus longus tendon serves as a robust and viable alternative autograft for ACLR. LEVEL OF EVIDENCE: Level III.