Systematic evaluation of anterior cruciate ligament
reconstruction with peroneus longus tendon and hamstring tendon

doi:10.3969/j.issn.2095-4344.1964

Abstract

Abstract:

BACKGROUND: In recent years, it has been reported that peroneus longus tendon can be used as a new graft material for anterior cruciate ligament reconstruction and can achieve the same effect as hamstring tendon. Therefore, it is necessary to systematically evaluate the two graft materials for anterior cruciate ligament reconstruction.

OBJECTIVE: To evaluate the clinical effect of reconstruction of anterior cruciate ligament with peroneus longus tendon and hamstring tendon by meta-analysis.

METHODS: We retrieved controlled clinical trials which compared the long peroneal tendons and hamstring tendons in reconstructing anterior cruciate ligament respectively in Chinese database (WanFang, CNKI, VIP, Chinese biological medicine) and English database (Ovid, PubMed, Web of Science, Embase, the Cochrane library). The retrieval time was from database creation to March 2019. Literature screening and evaluation and data extraction were performed by two evaluators. Meta-analysis was evaluated using Revman5.3 software.

RESULTS AND CONCLUSION: (1) A total of 413 Chinese or English literatures were retrieved and 10 of them were included in the final analysis. Among 647 patients receiving anterior cruciate ligament reconstruction, 271 patients used peroneus longus tendon reconstruction and 376 patients used hamstring tendon reconstruction. (2) Meta-analysis results: postoperative functional score: There was significant difference in Lysholm score at postoperative 12 months (MD=1.23, 95%CI[0.31, 2.51], P=0.000 9) and IKDC score at postoperative 6 months (MD=3.19, 95%CI[0.07, 6.31], P=0.02) between peroneus longus tendon reconstruction and hamstring tendon groups. The occurrence of postoperative complications in the peroneus longus tendon group was significantly lower than that in the hamstring tendon group (OR=0.15, 95%CI[0.03, 0.69], P=0.01). However, there were no significant differences in Tegner scores, degree of joint motion, degree of joint relaxation at postoperative 6 and 12 months between peroneus longus tendon reconstruction and hamstring tendon groups. No significant difference was found in Lysholm score at postoperative 6 months and in IKDC score at postoperative 12 months between these two groups. The results showed that the clinical effect of peroneus longus tendon in reconstruction of anterior cruciate ligament was comparable to that of hamstring tendon; in the peroneus longus tendon reconstruction group, the Lysholm score at postoperative 12 months and IKDC score at postoperative 6 months were significantly superior to those in the hamstring tendon group. The incidence of postoperative complications in the peroneus longus tendon reconstruction group was lower than that in the hamstring tendon group. The peroneus longus tendon can be clinically recommended to substitute hamstring tendon in the reconstruction of the anterior cruciate ligament. However, the quality of included literatures is limited; therefore higher quality of evidence is required to validate this conclusion.

Key words: peroneus longus tendon, hamstring tendon, reconstruction of anterior cruciate ligament, Lysholm scores, IKDC score, Tegner scores, range of motion, meta-analysis

CLC Number:

Shi Weifa, Guo Zhimin, Deng Huiyun, Shen Yanling, Shi Lingling, Wu Shilong, Huang Zebin. Systematic evaluation of anterior cruciate ligament reconstruction with peroneus longus tendon and hamstring tendon[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(5): 811-820.

Figures/Tables 21

References

[1] BICER EK, LUSTIG S, SERVIEN E, et al.Current knowledge in the anatomy of the human anterior cruciate ligament.Knee Surg Sports Traumatol Arthrosc.2010;18(8):1075-1084.
[2] SANDERS TL, KREMERS HM, BRYAN AJ, et al.Is Anterior Cruciate Ligament Reconstruction Effective in Preventing Secondary Meniscal Tears and Osteoarthritis? Am J Sports Med.2016;44(7):1699-1707.
[3] RAI S, JIN SY, RAI B, et al.A Single Bundle Anterior Cruciate Ligament Reconstruction (ACL-R) Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft: A Comparative Study. Curr Med Sci. 2018;38(5):818-826.
[4] GRASSI A, CARULLI C, INNOCENTI M, et al.New Trends in Anterior Cruciate Ligament Reconstruction: A Systematic Review of National Surveys of the Last 5 Years.Joints. 2018; 6(3):177-187.
[5] NAZEM K, BARZEGAR M, HOSSEINI A, et al.Can we use peroneus longus in addition to hamstring tendons for anterior cruciate ligament reconstruction? Adv Biomed Res. 2014;3: 115.
[6] PIETROSIMONE B, LOESER RF, BLACKBURN JT, et al. Biochemical markers of cartilage metabolism are associated with walking biomechanics 6-months following anterior cruciate ligament reconstruction.J Orthop Res.2017;35(10): 2288-2297.
[7] 李从中.自体腓骨长肌腱和腘绳肌腱在关节镜下重建膝关节前交叉韧带临床研究[J].北华大学学报(自然科学版),2018,19(3): 346-349.
[8] 柴昉,毕擎.自体腘绳肌腱与部分腓骨长肌腱重建前交叉韧带疗效比较[J].浙江医学,2018,40(14):1570-1573.
[9] 何衍高,梁春雨,张德新,等.应用腓骨长肌腱和腘绳肌腱重建前交叉韧带的疗效比较[J].实用骨科杂志, 2018，24(2):185-188.
[10] 马进宁,刘勇,王涛,等.取腓骨长肌腱和腘绳肌腱重建前交叉韧带的短期疗效对比研究[J].宁夏医学杂志,2016,38(8):710-712.
[11] 吴市春,郑亚才,严康宁,等.腓骨长肌腱与腘绳肌腱重建前交叉韧带的疗效比较[J].中国修复重建外科杂志,2015,29(11): 1358-1363.
[12] 柳学武,潘风雨,冯尚祥,等.关节镜下自体腓骨长肌腱与腘绳肌腱重建前交叉韧带比较分析[J].中国伤残医学, 2017,25(14): 5-8.
[13] 左金增,史福东.关节镜下腓骨长肌腱重建术治疗老年急性前交叉韧带断裂的疗效研究[J].中国全科医学,2018,21(30): 3718-3722.
[14] 刘仕杰,史福东,王雪臣,等.自体腓骨长肌腱和腘绳肌腱重建前交叉韧带术后疗效及移植物磁共振成像形态学变化研究[J].中国医药,2016,11(10):1538-1542.
[15] SHI FD, HESS DE, ZUO JZ, et al.Peroneus Longus Tendon Autograft is a Safe and Effective Alternative for Anterior Cruciate Ligament Reconstruction.J Knee Surg.2018.doi: 10.1055/s-0038-1669951.[Epub ahead of print]
[16] RHATOMY S, ASIKIN AIZ, WARDANI AE, et al.Peroneus longus autograft can be recommended as a superior graft to hamstring tendon in single-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2019.doi: 10.1007/s00167-019-05455-w.[Epub ahead of print]
[17] CONTE EJ, HYATT AE, GATT CJ JR, et al.Hamstring autograft size can be predicted and is a potential risk factor for anterior cruciate ligament reconstruction failure. Arthroscopy. 2014; 30(7):882-890.
[18] FIGUEROA F, FIGUEROA D, ESPREGUEIRA-MENDES J. Hamstring autograft size importance in anterior cruciate ligament repair surgery.EFORT Open Rev.2018;3:93-97.
[19] XIE G, HUANGFU X, ZHAO J.Prediction of the graft size of 4-stranded semitendinosus tendon and 4-stranded gracilis tendon for anterior cruciate ligament reconstruction: a Chinese Han patient study. Am J Sports Med. 2012;40: 1161-1166.
[20] FIGUEROA D, CALVO R, VAISMAN A, et al.Injury to the infrapatellar branch of the saphenous nerve in ACL reconstruction with the hamstrings technique: clinical and electrophysiological study.Knee. 2008;15(5):360-363.
[21] SANDERS B, ROLF R, MCCLELLAND W, et al.Prevalence of saphenous nerve injury after autogenous hamstring harvest: an anatomic and clinical study of sartorial branch injury. Arthroscopy.2007;23(9):956-963.
[22] CRISTIANI R, FORSSBLAD M, ENGSTROM B, et al.Risk Factors for Abnormal Anteroposterior Knee Laxity After Primary Anterior Cruciate Ligament Reconstruction. Arthroscopy. 2018;34(8): 2478-2484.
[23] CRISTIANI R, SARAKATSIANOS V, ENGSTROM B, et al. Increased knee laxity with hamstring tendon autograft compared to patellar tendon autograft: a cohort study of 5462 patients with primary anterior cruciate ligament reconstruction.Knee Surg Sports Traumatol Arthrosc.2019; 27:381-388.
[24] KIM HS, SEON JK, JO AR. Current trends in anterior cruciate ligament reconstruction. Knee Surg Relat Res. 2013;25:165-173.
[25] TSCHOLL PM, HALDEMANN VM, DE SMET A, et al.[How to choose the ideal graft for anterior cruciate ligament reconstruction]. Rev Med Suisse.2017;13(569):1339-1342.
[26] PALMER JE, RUSSELL JP, GRIESHOBER J, et al.A Biomechanical Comparison of Allograft Tendons for Ligament Reconstruction. Am J Sports Med.2017;45(3):701-707.
[27] ZHAO J, HUANGFU X.The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft source.Am J Sports Med. 2012;40(3): 662-671.
[28] KERIMOGLU S, KOSUCU P, LIVAOĞLU M, et al. Magnetic resonance imagination of the peroneus longus tendon after anterior cruciate ligament reconstruction.Knee Surg Sports Traumatol Arthrosc.2009;1(1):35-39.
[29] ANGTHONG C, CHERNCHUJIT B, APIVATGAROON A,et al. The Anterior Cruciate Ligament Reconstruction with the Peroneus Longus Tendon: A Biomechanical and Clinical Evaluation of the Donor Ankle Morbidity.J Med Assoc Thai. 2015;98(6):555-560.