ABSTRACT
BACKGROUND: In recent years, it has been reported that peroneus longus tendon can be used as a new graft material for anterior cruciate ligament reconstruction and can achieve the same effect as hamstring tendon. Therefore, it is necessary to systematically evaluate the two graft materials for anterior cruciate ligament reconstruction. OBJECTIVE: To evaluate the clinical effect of reconstruction of anterior cruciate ligament with peroneus longus tendon and hamstring tendon by meta-analysis. METHODS: We retrieved controlled clinical trials which compared the long peroneal tendons and hamstring tendons in reconstructing anterior cruciate ligament respectively in Chinese database (WanFang, CNKI, VIP, Chinese biological medicine) and English database (Ovid, PubMed, Web of Science, Embase, the Cochrane library). The retrieval time was from database creation to March 2019. Literature screening and evaluation and data extraction were performed by two evaluators. Meta-analysis was evaluated using Revman5. 3 software. RESULTS AND CONCLUSION: (1) A total of 413 Chinese or English literatures were retrieved and 10 of them were included in the final analysis. Among 647 patients receiving anterior cruciate ligament reconstruction, 271 patients used peroneus longus tendon reconstruction and 376 patients used hamstring tendon reconstruction. (2) Meta-analysis results: Postoperative functional score: There was significant difference in Lysholm score at postoperative 12 months (MD=1. 23, 95%C/[0. 31, 2. 51], P=0. 000 9) and IKDC score at postoperative 6 months (MD=3. 19, 95%C/[0. 07, 6. 31], P=0. 02) between peroneus longus tendon reconstruction and hamstring tendon groups. The occurrence of postoperative complications in the peroneus longus tendon group was significantly lower than that in the hamstring tendon group (OR=0. 15, 95%C/[0. 03, 0. 69], P=0. 01). However, there were no significant differences in Tegner scores, degree of joint motion, degree of joint relaxation at postoperative 6 and 12 months between peroneus longus tendon reconstruction and hamstring tendon groups. No significant difference was found in Lysholm score at postoperative 6 months and in IKDC score at postoperative 12 months between these two groups. The results showed that the clinical effect of peroneus longus tendon in reconstruction of anterior cruciate ligament was comparable to that of hamstring tendon; in the peroneus longus tendon reconstruction group, the Lysholm score at postoperative 12 months and IKDC score at postoperative 6 months were significantly superior to those in the hamstring tendon group. The incidence of postoperative complications in the peroneus longus tendon reconstruction group was lower than that in the hamstring tendon group. The peroneus longus tendon can be clinically recommended to substitute hamstring tendon in the reconstruction of the anterior cruciate ligament. However, the quality of included literatures is limited; therefore higher quality of evidence is required to validate this conclusion.