title: Donor Site Morbidity After Lateral Ankle Ligament Reconstruction Using the Anterior Half of the Peroneus Longus Tendon Autograft.
abstract: BACKGROUND
  The anterior half of the peroneus longus tendon (AHPLT) has been reported to be an effective autograft for ligament reconstruction with respect to strength and safety. However, there is little information regarding donor site morbidity after harvesting the AHPLT. Furthermore, to the best of our knowledge, there has not been a study on the isokinetic evaluation of ankle plantar flexion and eversion after AHPLT harvesting.
  
  
  OBJECTIVE
  To evaluate the clinical and radiographic results after lateral ankle ligament reconstruction using the AHPLT. We further investigated whether harvesting the AHPLT for lateral ankle ligament reconstruction decreases the strength of ankle plantar flexion and eversion.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Thirty consecutive patients (31 cases) were treated by anatomic lateral ligament reconstruction using the AHPLT. For the clinical assessment, visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Karlsson-Peterson scores were evaluated preoperatively and at the last follow-up. For the radiographic assessment, talar tilt angle and anterior talar displacement were measured preoperatively and at the last follow-up. The peak isokinetic torques for ankle plantar flexion at angular velocities of 30 and 120 deg/s and eversion at angular velocities of 30 and 60 deg/s were measured at a minimum of 1 year after surgery.
  
  
  RESULTS
  The mean VAS score improved significantly from 6.4 ± 1.7 preoperatively to 1.6 ± 1.5 at the last follow-up ( P < .001). The mean respective AOFAS and Karlsson-Peterson scores improved significantly from 57.2 ± 12.8 and 66.9 ± 13.6 preoperatively to 89.0 ± 10.0 and 93.3 ± 5.7 at the last follow-up ( P < .001). The mean talar tilt angle improved significantly from 15.3° ± 6.2° preoperatively to 3.4° ± 3.0° at the last follow-up ( P < .001), and the mean anterior talar displacement improved significantly from 10.2 ± 3.3 mm preoperatively to 6.3 ± 1.9 mm at the last follow-up ( P < .001). No significant differences were observed between the uninvolved and involved legs in the mean peak torque for plantar flexion at angular speeds of 30 deg/s ( P = .517) and 120 deg/s ( P = .347) or for eversion at angular speeds of 30 deg/s ( P = .913) and 60 deg/s ( P = .983).
  
  
  CONCLUSIONS
  Anatomic lateral ligament reconstruction using the AHPLT showed good clinical and radiographic results without a significant decrease in the peroneus longus strength. Lateral ligament reconstruction using the AHPLT may be a good surgical option for the treatment of chronic ankle instability.
authors.affiliation: Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Chul Hyun
authors.initials: CH
authors.lastname: Park
authors.affiliation: Seoul Foot and Ankle Center, Inje University Seoul Paik Hospital, Seoul, Korea.
authors.forename: Woo-Chun
authors.initials: WC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000601:surgery; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D012008:Recurrence; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D064232:Visual Analog Scale; D055815:Young Adult
keywords: autograft; chronic ankle instability; isokinetic test; lateral ligament reconstruction; peroneus longus tendon