Functional Outcomes Assessed by Lysholm and AOFAS Scores Following Arthroscopic ACL Reconstruction using Peroneus Longus Tendon Autograft: A Retrospective Study

Abstract

Background 
Anterior cruciate ligament (ACL) accounts for more than 50% of all knee injuries. Although arthroscopic ACL reconstruction (ACLR) is the standard treatment of complete ACL tear, graft selection remains variable. Recently, peroneus longus (PL) tendon autograft has gained attention. This study evaluates functional outcomes of arthroscopic ACLR with PL tendon autograft and assesses donor ankle morbidity.
Methods
This was a retrospective single-center descriptive study of 49 consecutive patients who underwent arthroscopic ACLR with PL tendon autograft at College of Medical Sciences-Teaching Hospital, Bharatpur from January 2024 to February 2025. Functional outcomes of knee were assessed by Lysholm score and donor ankle morbidity was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score. Descriptive statistics included frequency and percentage for categorical data and mean, range, standard deviation and 95% confidence interval (CI) for continuous variables. Comparative analysis was performed using an independent sample t-test with p-value <0.05 considered statistically significant.
Results
Mean age of patients was 34.98±11.46 years with male to female ratio of 0.88:1. Mean postoperative Lysholm score was 93.71±4.24 (range 80-100, 95% CI 92.49-94.93) at mean follow-up of 12.41±1.72 months. Male had significantly higher postoperative Lysholm score than female (95.65±3.49 vs 92.00±4.18, p=0.002). Mean AOFAS score was 96.35±3.62 (range 90-100, 95% CI: 95.31-97.39).
Conclusions
The present study demonstrates good to excellent functional outcome following arthroscopic ACLR with PL tendon autograft. Despite no control or preoperative comparison, postoperative AOFAS scores indicate minimal donor ankle morbidity at short-term follow-up.