Ipsilateral peroneus longus tendon graft in failed ACL reconstruction: Our experience

Failure of ACL reconstruction is very common and may be due to technical failure or new traumatic injuries. The graft options in these cases are very limited and may include taking graft from opposite leg or allograft. The allograft availability is very limited in our country and is also very expensive. The use of graft from opposite leg gives morbidity to other side also. We describe our experience of using ipsilateral peroneus longus graft for failed ACL reconstruction cases. Methodology: six patients with failed ACL reconstruction with age less than 40 years old and having normal knee ROM were included in the study. Clinical tests and Lysholm score were used to evaluate the outcome. Graft site morbidity was assessed using AOFAS Score and ankle disability test. Results: Lachmann test and Pivot shift test was positive in all the six cases while these tests were negative at one year follow up with no signs of instability. The average Lysholm score pre-op was 66+/- while it was of 87 +/- 5 at the end of one year follow-up. There was no case of graft failure and reoperation after one year. Donor site Mean pre- and postoperative AOFAS scores were 100.0 ± 0.0 and 96.0 ± 9.6, respectively at 6-month follow-up (p = 0.06). Conclusion: Ipsilateral peroneus longus graft can be used for reconstruction in failed ACL cases with minimal morbidity at donor site and good clinical outcome