腓骨长肌腱自体移植物用于前交叉韧带重建：当前证据、供区并发症与患者选择
简介
本综述总结腓骨长肌腱（PLT）作为ACL重建自体移植物的当前证据、供区并发症及患者选择。现有解剖、生物力学及临床证据显示，PLT移植物特性可靠，短至中期临床结果与常用自体移植物相近，供区功能总体良好，但证据以回顾性研究为主，尚无法确立等效或非劣效。临床可将其作为ACL重建的补充自体移植物选项，但需个体化评估，尤其关注高需求运动员踝关节功能及长期供区影响。
英文摘要
The search for the ideal autograft for anterior cruciate ligament (ACL) reconstruction (ACLR) remains a longstanding challenge in orthopaedic surgery, as each available graft possesses distinct advantages and inherent limitations. The peroneus longus tendon (PLT) has emerged as an alternative autograft, expanding graft options without further compromising the injured knee. Initially regarded with caution because of concerns regarding its role in foot and ankle biomechanics, the PLT has evolved into an increasingly recognised alternative autograft option supported by a growing body of anatomical, biomechanical and clinical evidence. The accumulating evidence suggests that the PLT provides reliable graft characteristics, while available comparative studies report broadly similar short- to mid-term clinical outcomes to established autografts and generally favourable donor-site function. However, the predominantly retrospective and heterogeneous evidence base does not establish graft equivalence or noninferiority. Although important questions remain, particularly regarding sport-specific ankle performance in high-demand athletes, long-term donor-site consequences and optimal harvest techniques, the available evidence supports consideration of the PLT as an additional autograft option for ACLR. Rather than establishing graft superiority, this editorial synthesises the current evidence, highlights the strengths and limitations of the PLT, and provides a practical framework for individualised ACL graft selection.