Comparison of Clinical and Functional Outcomes in Anterior Cruciate Ligament Reconstruction Using Peroneus Longus Tendon Versus Hamstring Tendon Autograft: A Prospective Comparative Study

Background Anterior cruciate ligament (ACL) reconstruction is among the most commonly performed knee procedures worldwide. Hamstring tendon autografts remain a popular graft choice but are associated with donor-site morbidity and postoperative thigh muscle weakness. The peroneus longus tendon has recently emerged as a promising alternative due to its favorable biomechanical strength and reportedly low ankle morbidity. However, detailed evidence comparing early functional recovery between these two graft options remains limited. Objective This study aims to compare the clinical and functional outcomes of ACL reconstruction using the peroneus longus tendon autograft versus the hamstring tendon autograft over a 6-month postoperative period. Materials and methods This prospective comparative study was conducted at a tertiary care center in India and included 50 patients with isolated ACL tears requiring primary single-bundle arthroscopic reconstruction. Participants were divided into two groups: Group A (peroneus longus autograft, n=25) and Group B (hamstring autograft, n=25) based on shared decision-making. Outcome measures included International Knee Documentation Committee (IKDC) scores, Lysholm scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, thigh circumference, ankle range of motion, and clinical knee stability tests. Assessments were performed preoperatively and at 1, 2, 3, and 6 months postoperatively. Statistical analyses utilized independent t-tests, paired t-tests, and chi-square tests or Fisher's exact test with significance set at p