COMPARISON OF OUTCOMES BETWEEN HAMSTRING TENDON GRAFT VERSUS PERONEUS LONGUS TENDON GRAFT IN ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION

Abstract

Background: Anterior Cruciate Ligament (ACL) reconstruction is one of the most common orthopaedic surgeries carried out around the world. Although HT autograft has been the preferred method for a long time, donor site morbidity has prompted a quest for alternatives. The PLT autograft is regarded as a new, promising technique for its biomechanical benefits.

Objective: To compare postoperative functional outcomes and knee stability between HT and PLT autografts in primary ACL reconstruction.

Methodology: An non- randomized comparative study was done at Ghurki Trust Teaching Hospital, Lahore, during January 2026 to May 2026. Ninety-six patients (48 in each group) between the ages of 20 and 45 years who had suffered from ACL injuries were selected using a sequential sampling method. Functional assessment was done after 3 months using the Lysholm Knee Score System, while knee joint stability was measured using the Lachman test.

Results: For the PLT group, a significant increase was observed in the mean postoperative Lysholm score (96.2±2.4 vs. 93.8±3.6; p = 0.0002), and there was an increased number of patients presenting Grade 0 Lachman findings (95.8% vs. 81.3%; p = 0.02). There was a lower rate of complications reported for the PLT group (4.2% vs. 14.6%), though not statistically significant (p=0.08). Stratified analyses confirmed consistent superiority of PLT across all subgroups.

Conclusion: PLT autograft demonstrates better functional results and joint stability when compared to HT autograft for primary anterior cruciate ligament reconstruction surgery. This evidence suggests that PLT is an ideal option for a primary graft choice, especially in cases where hamstrings need to be conserved.