腓骨长肌腱与腘绳肌腱自体移植物在前交叉韧带重建中的比较：移植物直径与供区并发症分析
简介
这项回顾性研究比较了腓骨长肌腱与腘绳肌腱自体移植物用于ACL重建的临床结局、膝关节稳定性及供区并发症，每组15例，随访至少2年。两组的Lysholm、IKDC评分及整体膝关节稳定性相当（P>0.05）；腓骨长肌腱的初始直径（平均8.71 mm）大于腘绳肌腱（平均7.65 mm）（P<0.001），腘绳肌腱组有6例因术中测量直径不足7.5 mm而由4股增至6股…
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.