Background: The selection of graft for revision anterior cruciate ligament (ACL) reconstruction is limited. The ideal graft choice remained undetermined. Purpose: The purpose of this study was to evaluate the outcomes of revision ACL reconstruction with peroneus longus tendon (PLT) autografts at 2- to 3-year follow-ups. Methods: The study included 10 patients (4 males, 6 females), with a mean age of 36 years (range, 18-63), who were diagnosed with failed ACL reconstruction from January 2016 to May 2017 based on objective instability, traumatic reinjury, or subjective persisting pain. They underwent revision reconstruction using ipsilateral PLT grafts, fixation via Endobutton (Smith & Nephew, Andover, MA, USA) and interference screws. The patients underwent regular follow-ups after the clinical and radiographic preoperative and postoperative evaluations. The follow-up examinations comprised the International Knee Documentation Committee (IKDC) subjective knee evaluation score, Lysholm knee score, and American Orthopedic Foot and Ankle Society-hindfoot score (AOFAS). Results: The subjective IKDC score progressed from 44.5 preoperatively to 85.4 in the last postoperative follow-up; the average Lysholm score was 88.5 postoperatively, and most patients (9 of 10) were categorized as "excellent" or "good". The AOFAS of the graft harvest site showed good results (average, 98; range, 90-100). There were patients who reported mild pain and stiffness in the donor site, but none of them experienced donor site paresthesia, dysesthesia or ankle joint dysfunction due to the PLT transfer. Conclusion: The PLT is a suitable graft choice for revision ACL reconstruction, yielding minor donor site morbidity.
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