Altered gait biomechanics after peroneus longus tendon harvest for anterior cruciate ligament reconstruction : truth or myth?

Abstract

The aim of this study was to evaluate the impact of peroneus longus tendon (PLT) harvest on gait biomechanics following anterior cruciate ligament (ACL) reconstruction. There is scarce evidence in the literature about the safety of PLT as a potential graft for ACL reconstruction, and no long-term studies with gait assessment exist. We analyzed changes in spatiotemporal parameters (STPs) using a computerized gait analysis system and assessed functional ambulation over time. This prospective cohort study included 31 patients, including 23 males and eight females. The mean agewas 32.61 years (SD 10.60), with a mean clinical follow-up of 18.34 months (SD 6.25). The mean height, weight, and BMI were 160.23 cm (SD 8.08), 72.39 kg (SD 10.95), and 28.32 kg/m² (SD 4.74), respectively. Gait analysis was performed preoperatively and postoperatively at six months and one year. Various STPs along with Functional Ambulation Profile (FAP) scores were assessed. Comparison of study variables between different time intervals was done using repeated measures analysis of variance followed by Bonferroni post-hoc test. A p-value < 0.05 was considered statistically significant. Cadence, FAP score, single-leg support time, step time, and velocity increased significantly over different time intervals (p < 0.001). No significant difference in stride length, double support time, stance time, and swing time were noted over different time intervals. Despite overall improvements in functional gait, PLT harvest for ACL reconstruction resulted in subtle gait alterations, notably prolonged single-leg support time. Although compensatory mechanisms help to preserve gait function, these changes require careful consideration, particularly in athletes. Incorporating targeted ankle rehabilitation may help to reduce potential long-term effects. Further research is necessary to evaluate its impact on foot biomechanics and stability.