Full-Thickness Peroneus Longus Tendon Autograft Harvest
Background: Despite extensive evidence of excellent biomechanical and clinical outcomes of ligament reconstructions with bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon autografts, these are not without limitations, including knee-related donor site morbidity, decreased range of m...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-11-01
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| Series: | Video Journal of Sports Medicine |
| Online Access: | https://doi.org/10.1177/26350254231195093 |
| _version_ | 1797635674753466368 |
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| author | Carlos E. Franciozi MD, PhD Enzo S. Mameri MD, MSc Felipe C. Schumacher MD Marcos V. Credidio MD Marcelo S. Kubota MD Marcus V. Luzo MD, PhD |
| author_facet | Carlos E. Franciozi MD, PhD Enzo S. Mameri MD, MSc Felipe C. Schumacher MD Marcos V. Credidio MD Marcelo S. Kubota MD Marcus V. Luzo MD, PhD |
| author_sort | Carlos E. Franciozi MD, PhD |
| collection | DOAJ |
| description | Background: Despite extensive evidence of excellent biomechanical and clinical outcomes of ligament reconstructions with bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon autografts, these are not without limitations, including knee-related donor site morbidity, decreased range of motion, and potential for anterior knee pain. Therefore, researchers have explored other options, including the peroneus longus (PL) autograft. Indication: Anterior cruciate ligament (ACL) reconstruction (both primary and revision), as well as multiligament reconstruction, particularly in areas where access to allografts is limited. Surgical Technique: A 3-cm longitudinal skin incision is placed 2 fingerbreadths (or 3 cm) proximal to the tip of the lateral malleolus, and 3 mm posterior to the fibula. The PL and peroneus brevis tendons are identified and isolated, followed by a tenodesis at the distal limit of the incision. The PL is whipstitched proximal to the tenodesis site, and then incised between the tenodesis and whipstitched portion. A closed tendon stripper is inserted and advanced proximally until the PL graft is released. Discussion/Conclusion: PL autograft harvest has been shown to generate thicker and longer grafts relative to the semitendinosus, with demonstrated efficacy in terms of both biomechanical and clinical outcomes. Current literature points largely to a good safety profile, although there is still conflicting evidence in terms of foot and ankle morbidity and no mid- to long-term follow-up data available. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form. |
| first_indexed | 2024-03-11T12:23:47Z |
| format | Article |
| id | doaj.art-6b89cfb3e23642878a2db31291e70d87 |
| institution | Directory Open Access Journal |
| issn | 2635-0254 |
| language | English |
| last_indexed | 2024-03-11T12:23:47Z |
| publishDate | 2023-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Video Journal of Sports Medicine |
| spelling | doaj.art-6b89cfb3e23642878a2db31291e70d872023-11-06T13:33:46ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542023-11-01310.1177/26350254231195093Full-Thickness Peroneus Longus Tendon Autograft HarvestCarlos E. Franciozi MD, PhD0Enzo S. Mameri MD, MSc1Felipe C. Schumacher MD2Marcos V. Credidio MD3Marcelo S. Kubota MD4Marcus V. Luzo MD, PhD5Hospital Israelita Albert Einstein, São Paulo, BrazilInstituto Brasil de Tecnologia da Saúde, Rio de Janeiro, BrazilDepartment of Orthopedics and Traumatology—EPM, UNIFESP, São Paulo, BrazilDepartment of Orthopedics and Traumatology—EPM, UNIFESP, São Paulo, BrazilDepartment of Orthopedics and Traumatology—EPM, UNIFESP, São Paulo, BrazilDepartment of Orthopedics and Traumatology—EPM, UNIFESP, São Paulo, BrazilBackground: Despite extensive evidence of excellent biomechanical and clinical outcomes of ligament reconstructions with bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon autografts, these are not without limitations, including knee-related donor site morbidity, decreased range of motion, and potential for anterior knee pain. Therefore, researchers have explored other options, including the peroneus longus (PL) autograft. Indication: Anterior cruciate ligament (ACL) reconstruction (both primary and revision), as well as multiligament reconstruction, particularly in areas where access to allografts is limited. Surgical Technique: A 3-cm longitudinal skin incision is placed 2 fingerbreadths (or 3 cm) proximal to the tip of the lateral malleolus, and 3 mm posterior to the fibula. The PL and peroneus brevis tendons are identified and isolated, followed by a tenodesis at the distal limit of the incision. The PL is whipstitched proximal to the tenodesis site, and then incised between the tenodesis and whipstitched portion. A closed tendon stripper is inserted and advanced proximally until the PL graft is released. Discussion/Conclusion: PL autograft harvest has been shown to generate thicker and longer grafts relative to the semitendinosus, with demonstrated efficacy in terms of both biomechanical and clinical outcomes. Current literature points largely to a good safety profile, although there is still conflicting evidence in terms of foot and ankle morbidity and no mid- to long-term follow-up data available. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.https://doi.org/10.1177/26350254231195093 |
| spellingShingle | Carlos E. Franciozi MD, PhD Enzo S. Mameri MD, MSc Felipe C. Schumacher MD Marcos V. Credidio MD Marcelo S. Kubota MD Marcus V. Luzo MD, PhD Full-Thickness Peroneus Longus Tendon Autograft Harvest Video Journal of Sports Medicine |
| title | Full-Thickness Peroneus Longus Tendon Autograft Harvest |
| title_full | Full-Thickness Peroneus Longus Tendon Autograft Harvest |
| title_fullStr | Full-Thickness Peroneus Longus Tendon Autograft Harvest |
| title_full_unstemmed | Full-Thickness Peroneus Longus Tendon Autograft Harvest |
| title_short | Full-Thickness Peroneus Longus Tendon Autograft Harvest |
| title_sort | full thickness peroneus longus tendon autograft harvest |
| url | https://doi.org/10.1177/26350254231195093 |
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