Functional Results of Anterior Cruciate Ligament Reconstruction in Manual Workers Using Peroneus Longus Tendon Graft

Abstract

BackgroundAnterior cruciate ligament (ACL) tears in manual workers often need reconstruction and the knee joint has to return to the utmost functional results as it will be subjected to huge stresses upon returning to work. There were earlier reports of lesser outcomes in manual workers sustaining spine or upper limb injuries in comparison with other patient groups. The peroneus longus tendon autograft (PLTA) is easy to harvest, however, the concerns about its use include the donor site morbidity and the possible damage to the common peroneal nerve (CPN). In this study, the functional results of arthroscopic ACL reconstruction (ACLR) in manual workers both in terms of knee stability and ability to return to the same level of work will be discussed as well as the ankle joint function after harvesting PLTA.Patients and MethodsBetween April 2019 and February 2023, 27 manual workers (comprising of 23 men and 4 women) aged between 19 and 39 (average age of 29.7, standard deviation of 5.9) received arthroscopic ACLR with PLTA. The average length of time between the injury and reconstruction surgery was 17 weeks, with a range of 6 weeks to 29 weeks and a SD of 6.2. The follow-up period varied between 9 and 25 months (average 18.1 months; SD 4.5).ResultsAfter surgery, the average degree of movement ranged from 2.4° of hyperextension (10–0°) to 133.5° of flexion (110–150°), with a SD of 3.2 and 12.3, respectively. The Lachman test, the anterior drawer test, and the pivot shift test showed significant improvement following the reconstruction procedure (P<0.001). After surgery, there were important statistical improvements in the functional knee score, which comprised the Tegner activity score, Tegner-Lysholm Knee score, and modified Cincinnati knee rating system (P<0.001). Additionally, after the operation, the American orthopedic foot and ankle society score and foot and ankle disability index demonstrated exceptional results. No postoperative neurological damage was experienced by any of the cases. Every patient was able to resume work within an average of 20.8 weeks, with a range of 14–28 weeks and a SD of 4.ConclusionsReconstruction of the ACL tears with the PLTA seems safe. It didn’t result in an excessive delay in return to work, so it can be used safely in the manual workers’ population.