Abstract
<title>Abstract</title> <p>Background: The quadriceps tendon, hamstring tendons, and bone–patellar tendon–bone transplants are among the numerous autograft alternatives that are currently available for anterior cruciate ligament (ACL) reconstruction. Current research is being conducted to investigate alternative transplantation sources in order to mitigate donor-site complications and ensure comparable stability. Recently, the peroneus longus tendon has garnered attention as a potential graft for ACL reconstruction among these alternatives. Aim: To assess the clinical and functional outcomes of ACL using peroneus longus tendon autografts and hamstring tendon autografts. Methods This randomized controlled trial included 42 cases with isolated complete ACL tears. Participants were randomly allocated to 2 groups according to graft used for reconstruction. Twenty cases underwent reconstruction using hamstring tendon autografts, whereas twenty-two patients received peroneus longus tendon autografts. The Lysholm knee score and the International Knee Documentation Committee (IKDC) score were employed to assess functional outcomes. All patients were monitored for over 12-month period following surgery. Results The mean graft diameter of the peroneus longus group was significantly greater than that of the hamstring tendon group (9.9 ± 0.6 mm versus 8.5 ± 0.5 mm, p = 0.001). The postoperative scores of both IKDC and Lysholm were significantly improved in each group (p < 0.001). Furthermore, knee stability improved substantially in both groups without significant differences between them. Conclusion The peroneus longus tendon is a dependable autograft option for ACL reconstruction. While also having the potential to reduce donor-site morbidity, it offers functional and clinical outcomes that are comparable to those of hamstring tendon transplantation.</p>