Functional outcome of arthroscopically assisted anterior cruciate ligament reconstruction using peroneus longus tendon autograft

Background: Anterior cruciate ligament (ACL) injuries are among the most frequent knee injuries encountered in young and physically active individuals. Arthroscopic ACL reconstruction remains the gold standard for restoring knee stability and function. Selection of an ideal graft continues to be debated. Recently, the peroneus longus tendon (PLT) has been proposed as an alternative autograft owing to its favorable biomechanical properties and minimal donor-site morbidity.Objective: To evaluate the functional outcome of arthroscopically assisted ACL reconstruction using peroneus longus tendon graft.Materials and Methods: This prospective observational study was conducted on 60 patients with isolated ACL rupture undergoing arthroscopically assisted ACL reconstruction using peroneus longus tendon graft between 15 March 2025 and 15 September 2025. Functional outcomes were assessed preoperatively and at 6 months postoperatively using the International Knee Documentation Committee (IKDC) score, Lysholm Knee Score, and Tegner Activity Scale.Results: The mean age of patients was 26.8 ± 5.4 years. Statistically significant improvement was observed in all functional scores at 6 months follow-up. Mean IKDC score improved from 41.2 ± 6.8 preoperatively to 86.5 ± 5.9 postoperatively (p < 0.001). Lysholm score improved from 48.7 ± 7.1 to 90.3 ± 4.8. No patient reported ankle instability or significant donor-site morbidity.Conclusion: Peroneus longus tendon is a safe and effective autograft for arthroscopic ACL reconstruction, providing excellent short-term functional outcomes with minimal complications.