Peroneus Longus Tendon Graft to Reconstruct the Posterolateral Corner of the Knee^[*]

Abstract

The posterolateral corner is critical to knee stability. Neglected injuries have a direct impact on the prognosis due to residual instability, chronic pain, deformities, and failure to repair other structures. Several techniques are used to reconstruct the posterolateral corner, often with autologous ischiotibial grafts or homologous grafts. An option little used for knee ligament reconstructions is the peroneus longus tendon graft. Although reported as a good alternative for anterior cruciate ligament reconstruction, we found no case using a peroneus longus tendon graft for posterolateral corner reconstruction. Here, we describe the case of a patient who underwent a non-anatomical reconstruction of the posterolateral corner using a peroneus longus tendon graft.

The patient underwent surgical procedures for ligament reconstruction and correction of the deformity caused by a failed graft, but his knee remained unstable. During the preoperative planning, it was decided to reconstruct the posterolateral corner with an ipsilateral peroneus longus tendon graft.

Studies have shown that the peroneus longus tendon graft does not increase ankle morbidity, and that its length and diameter favor ligament reconstruction. Thus, the present article highlights the importance of the proper diagnosis of ligament injuries in the acute phase, and describes a new technique for posterolateral corner reconstruction that must be included in the surgeon's body of knowledge, increasing the amount of technical options.

Keywords

autograft - joint instability - anterior cruciate ligament injuries - anterior cruciate ligament reconstruction

Financial Support

There was no financial support from public, commercial, or non-profit sources.

^* Study developed at Faculdade de Ciências Médicas, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

Publication History

Received: 09 September 2020

Accepted: 30 November 2020

Article published online:
20 December 2021

• Referências

• 1 Welsh P, DeGraauw C, Whitty D. Delayed diagnosis of an isolated posterolateral corner injury: a case report. J Can Chiropr Assoc 2016; 60 (04) 299-304
• 2 Crespo B, James EW, Metsavaht L, LaPrade RF. Lesões do canto posterolateral do joelho: uma revisão completa da anatomia ao tratamento cirúrgico. Rev Bras Ortop 2015; 50 (04) 363-370
• 3 Kerimoğlu S, Aynaci O, Saraçoğlu M, Aydin H, Turhan AU. [Anterior cruciate ligament reconstruction with the peroneus longus tendon]. Acta Orthop Traumatol Turc 2008; 42 (01) 38-43
• 4 Rhatomy S, Asikin AIZ, Wardani AE, Rukmoyo T, Lumban-Gaol I, Budhiparama NC. Peroneus longus autograft can be recommended as a superior graft to hamstring tendon in single-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2019; 27 (11) 3552-3559
• 5 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 2019; 32 (08) 804-811
• 6 Bi M, Zhao C, Zhang S, Yao B, Hong Z, Bi Q. All-Inside Single-Bundle Reconstruction of the Anterior Cruciate Ligament with the Anterior Half of the Peroneus Longus Tendon Compared to the Semitendinosus Tendon: A Two-Year Follow-Up Study. J Knee Surg 2018; 31 (10) 1022-1030
• 7 Nazem K, Barzegar M, Hosseini A, Karimi M. Can we use peroneus longus in addition to hamstring tendons for anterior cruciate ligament reconstruction?. Adv Biomed Res 2014; 3: 115