Comparison of Peroneus Longus Tendon Autograft and Hamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction: A Systematic Review


  • I Putu Surya Fajari Widhiarma General Practitioner
  • I Wayan Murjana Consultant of Orthopaedic and Traumatology, Sport Injury and Arthroscopy at Kasih Ibu Hospital, Denpasar, Bali, Indonesia
  • I Kadek Dwiki Anjasmara Faculty of Medicine and Health Science Undiksha University, Bali, Indonesia



Peroneus longus tendon, Hamstring Tendon, Anterior cruciate ligament, Reconstruction, ACL


Purpose: The aim of this study to compare the outcomes between peroneus longus tendon autograft versus hamstring tendon autograft for anterior cruciate ligament reconstruction such as International Knee Decumentation Committee (IKDC), Lysholm score, Modofied cincinnati score, Tegner activity scale and donor site morbidity.

Methods: This systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Multiple databases were searched for studies that compared functional outcomes of ACL reconstruction with peroneus longus tendon autograft versus hamstring tendon autografts with minimum 1 year follow-up.

Result: We analyzed 5 studies included direct comparison of peroneus longus tendon (106 patients) versus hamstring tendon (137 patients). There was no significant diferrence comparison of the outcome such as Modified cincinnati, Tegner scale activity and  Lysholm score. On IKDC score, 1 studies reported there was a significant difference between peroneus longus tendon autograft 87.4 (67.8-100) versus hamstring tendon autograft 78.2 (35.6-95.6) with p=0. Two studies reported donor site morbidity mostly occured in hamstring tendon autograft (11.4 ± 3.6) were higher than peroneus longus tendon (2.5 ± 0.5) (P=0.002). The knee flexion of donor site morbidity in peroneus longus tendon group (41.97 ± 1.98) higher than hamstring tendon group (40.65 ± 1.74) (P=0.02).

Conclusion: This study was concluded there was no significant differrence of comparison between peroneus longus group and hamstring group after ACL reconstruction but IKDC score after reconstruction could be affected by gender and graft size. Donor site morbidity most occured in hamstring group than peroneus longus group after ACL reonstruction.


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