腓骨长肌腱自体移植物行ACL重建不会损害踝关节功能：327例患者随访至少2年的回顾性研究
简介
回顾性分析327例采用四股腓骨长肌腱（PLT）自体移植物行ACL重建、取腱后未行远端腱固定的患者，随访至少2年（平均42.17个月），术前及术后6、24个月采用AOFAS踝-后足评分、FADI和VAS评估踝关节功能。各时间点VAS疼痛评分均较低且无显著变化（P=0.097），AOFAS和FADI评分自术前至术后2年持续较高、未见显著下降。该单组回顾性研究（I…
英文摘要
PURPOSE: The goal of this study was to assess whether harvesting the peroneus longus tendon (PLT) for anterior cruciate ligament reconstruction (ACLR) affects ankle function over time, using data from a large group of patients with at least 2 yrs of follow-up. METHODS: We retrospectively reviewed 327 patients who underwent ACLR using a quadrupled PLT graft without distal tenodesis after harvest. Ankle function was evaluated before surgery and at 6 and 24 months postoperatively using three validated tools: the AOFAS Ankle Hindfoot Score, the Foot and Ankle Disability Index (FADI), and the Visual Analogue Scale (VAS) for pain. Activity levels before injury were recorded using the Tegner Activity Scale. Changes in scores over time were analysed using the Friedman test. RESULTS: Patients were followed for an average of 42.17 months. Preoperative Tegner scores suggested most patients had low to moderate activity levels. Ankle pain remained minimal across all time points, with no significant changes in VAS scores (p = 0.097). Both AOFAS and FADI scores remained consistently high from before surgery to two years after, with no significant decline. These findings suggest that harvesting the peroneus longus tendon does not result in clinically significant donor-site ankle morbidity over long-term follow-up. CONCLUSION: Use of the peroneus longus tendon for anterior cruciate ligament reconstruction appears to be a safe and effective option that does not compromise clinical ankle function in low- to moderate-activity individuals. Our findings, based on a large cohort with minimum 2 year follow up, support PLT autograft as a reliable alternative with minimal donor site morbidity. LEVEL OF EVIDENCE: Level IV.