暂无摘要。

UNASSIGNED: Many kinds of grafts were used for single-bundle reconstruction of the posterior cruciate ligament (PCL). Recently, the peroneus longus tendon (PLT) was used in some clinical reports. This study aimed to test the best position of the femoral insertion in the case of using PLT for PCL reconstruction.
UNASSIGNED: Seventeen fresh frozen cadaveric knees were randomized into three groups. Group AL (6 knees): the femoral insertion in PCL reconstruction was at the footprint center of the anterolateral bundle (ALB). Group PM (5 knees): at the footprint center of the posteromedial bundle (PMB). And group MC (6 knees) was at the midpoint of the center of the anterolateral bundle and posteromedial bundle. The PCL of all knees was cut and a PCL reconstruction procedure was performed with autologous peroneus longus tendon (PLT). The stability of each knee was tested in three conditions: PCL was intact, PCL was resected, and PCL was reconstructed. The KT-1000 machine was used to measure the maximum posterior displacement of the tibia under force with the knees at 0, 30, 60, 90, and 120 degrees of flexion.
UNASSIGNED: Average posterior displacement of the tibia under force for intact PCL of group AL was 1.6 mm, group MC was 1.2 mm, and group PM was 1.3 mm. After PCL was resected, the knee laxity was increased remarkably: posterior displacement of the tibia of group AL was 8.9 mm, group MC was 9.4 mm, and group PM was 13.6 mm. After PCL was reconstructed, group AL was 1.5 mm, group MC was 2.0 mm, and group PM was 5.6 mm. The results showed that after PCL reconstruction the group AL and group MC give better stability to the knee (p < 0.05, except knee at 120 degrees of flexion). Group AL got more stability than group MC, but the difference was not significant (p ≥ 0.164).
UNASSIGNED: In a single-bundle reconstruction of the PCL with the graft PLT, the femoral insertion at the footprint center of the ALB and the midpoint of the center of the ALB and PMB showed better stability than that at PMB.

BACKGROUND: The present study was done to analyze the functional outcome, donor site morbidities, and associated parameters when using the anterior half of the peroneus longus for augmentation of an inadequate hamstring graft when performing arthroscopic anterior cruciate ligament (ACL) reconstruction.
METHODS: Thirty patients with complete ACL tears were operated on. In all these patients, the thickness or length of the hamstring graft taken was found to be inadequate (less than 8 mm and 7.5 cm, respectively). So, additionally, the anterior half of the peroneus longus tendon (AHPLT) graft was harvested to reach an optimum size of the final graft. Functional outcome was assessed using the International Knee Documentation Committee (IKDC) score at six weeks, three months, and six months. The Foot and Ankle Disability Index (FADI) score at six months was used to assess ankle stability.
RESULTS: The mean age in our study was 28.8 years with male predominance (73.33%). The mean operative time was 86.4 minutes. The mean hamstring graft thickness in our study was 6.5 mm, which improved to 9.12 mm after augmentation. The mean graft length after AHPLT augmentation was 9.38 cm. The mean IKDC score at six months was 87.35. At the end of six months, FADI scores were found within normal limits (range: 135-136) in all the patients. No complications were noted in any of the patients.
CONCLUSIONS: The AHPLT graft was always found to be sufficient enough for augmenting the hamstring graft to reach an acceptable thickness and length. There was no graft site morbidity and the ankle functional levels remained the same as preoperative levels, making it an excellent choice for augmentation of inadequate hamstring grafts.

OBJECTIVE: To evaluate the distances using ultrasound between the superficial peroneal nerve (SPN) and sural nerve along the peroneus longus tendon (PLT) autograft harvest path at different ankle or knee positions in order to minimize risk of iatrogenic nerve injury during PLT autograft harvest.
METHODS: Twenty-four fresh-frozen human cadaveric lower extremities were used to harvest a full-thickness PLT autograft with a tendon stripper. Four specimens were utilized to validate correct identification of nerves under ultrasound. Sonographically guided perineural injections were performed at the start point and end point of the PLT harvest path using coloured latex, followed by dissection with gross inspection. Using ultrasound, the distance from the peroneus brevis muscle to the sural nerve at different ankle positions (20° dorsiflexion, neutral, and 20° plantarflexion) was measured, and the distance from the end of the tendon stripper to the SPN at different knee positions (full extension and 90° flexion) was also measured. Measurements were performed by two separate observers using ImageJ software.
RESULTS: Cadaveric dissection showed the presence of latex around nerves in all four specimens. The average distance from the brevis muscle to the sural nerve increased significantly from dorsiflexion to plantarflexion. The shortest distance from the tenodesis site to the sural nerve was 5.8 ± 1.7 mm. There was no significant difference from the end of the tendon stripper to the SPN between full extension or 90° flexion of the knee.
CONCLUSIONS: When harvesting the PLT, it is recommended to place the ankle at plantarflexion. The knee at full extension or 90° flexion had no effect. Joint positions at the time of graft harvest should be monitored to reduce risks of iatrogenic nerve injury.

UNASSIGNED: To discuss the effectiveness of posterior cruciate ligament (PCL) reconstruction with autologous peroneus longus tendon under arthroscopy.
UNASSIGNED: Between January 2016 and December 2018, 46 patients with PCL injuries were enrolled. There were 34 males and 12 females, with an average age of 40.7 years (range, 20-58 years). There were 43 cases of acute injury and 3 cases of old injury. The anterior drawer test and the posterior tibia sign were positive in 4 cases, the posterior drawer tests and the posterior tibia sign were positive in 46 cases, the varus stress tests were positive in 10 cases, and the valgus stress tests were positive in 6 cases. The difference of dial-test at 30° knee flexion between affected and healthy sides was (5.20±3.91)°. The tibia posterior displacement under posterior stress position was (12.03±2.38) mm. The Lysholm score of the knee joint was 36.68±7.89, the International Knee Documentation Committee (IKDC) score was 33.58±5.97, and the American Orthopaedic Foot and Ankle Association (AOFAS) score of the ankle joint was 97.60±1.85. PCL was reconstructed with autologous peroneus longus tendon under arthroscopy, and the combined meniscus injury, posterolateral complex injury, and anterior cruciate ligament injury were all treated according to the degree of injury.
UNASSIGNED: All incisions healed by first intention. Forty patients were followed up 12-26 months, with an average of 16.0 months. At last follow-up, the Lysholm score of the knee joint was 84.85±7.03, and the IKDC score was 87.13±6.27, which were significant different from preoperative ones ( t=-13.45, P=0.00; t= -39.12, P=0.00); the AOFAS score of ankle joint was 93.98±2.14, which was not significant different from preoperative one ( t=8.09, P=0.90). The tibia posterior displacement under posterior stress position was (2.75±1.76) mm and the difference of dial-test at 30° knee flexion between affected and healthy sides was (1.75±2.09)°, which were significant different from preoperative ones ( t=29.00, P=0.00; t=4.96, P=0.00). The posterior drawer test and the posterior tibia sign were positive in 1 case and negative in 39 cases; the anterior drawer test and the varus and valgus stress tests were all negative.
UNASSIGNED: Reconstruction of PCL with autologous peroneus longus tendon under arthroscopy can significantly improve the stability and function of the knee joint, with satisfactory clinical results.
UNASSIGNED: 探讨关节镜下自体腓骨长肌腱重建膝关节后交叉韧带（posterior cruciate ligament，PCL）的疗效。.
UNASSIGNED: 2016 年 1 月—2018 年 12 月，收治 46 例膝关节 PCL 损伤患者。男 34 例，女 12 例；年龄 20～58 岁，平均 40.7 岁。急性损伤 43 例，陈旧性损伤 3 例。术前前抽屉试验阳性 4 例、后抽屉试验及胫骨后沉征阳性 46 例，内翻应力试验阳性 10 例、外翻应力试验阳性 6 例；屈膝 30° 位拨号试验患健侧差值为（5.20±3.91）°；后向应力位胫骨后移距离（12.03±2.38）mm。膝关节 Lysholm 评分为（36.68±7.89）分，国际膝关节文献委员会（IKDC）评分为（33.58±5.97）分，踝关节美国矫形足踝协会（AOFAS）评分为（97.60±1.85）分。关节镜下采用自体腓骨长肌腱解剖重建 PCL，合并的半月板损伤、后外侧复合体损伤及前交叉韧带损伤均根据损伤程度进行对应处理。.
UNASSIGNED: 术后切口均Ⅰ期愈合。40 例患者获随访，随访时间 12～26 个月，平均 16.0 个月。末次随访时，膝关节 Lysholm 评分为（84.85±7.03）分、IKDC 评分为（87.13±6.27）分，与术前比较差异均有统计学意义（ t=−13.45， P=0.00； t=−39.12， P=0.00）；踝关节 AOFAS 评分为（93.98±2.14）分，与术前比较差异无统计学意义（ t=8.09， P=0.90）。后向应力位胫骨后移距离为（2.75±1.76）mm、屈膝 30° 位拨号试验患健侧差值为（1.75±2.09）°，与术前比较差异均有统计学意义（ t=29.00， P=0.00； t=4.96， P=0.00）。后抽屉试验及胫骨后沉征阳性 1 例，阴性 39 例；前抽屉试验以及内、外翻应力试验均为阴性。.
UNASSIGNED: 关节镜下自体腓骨长肌腱重建 PCL 能显著改善膝关节稳定性和功能，临床疗效满意。.

In recent years, the use of the anterior half of the peroneus longus tendon (AHPLT) as an autograft source for ligament reconstruction has gained popularity. However, no reports are available regarding tendon regeneration after harvesting of the AHPLT.
When half of the tendon is preserved during tendon harvesting, the quality of the regenerated tendon is better than that of the regenerated tendon after full-thickness harvesting.
Case series; Level of evidence, 4; controlled laboratory study.
A total of 21 patients who underwent AHPLT harvesting for lower extremity ligament reconstruction participated in the magnetic resonance imaging (MRI) study to evaluate tendon regeneration 1 year after the harvesting. An in vivo animal study was performed to compare the quality of the regenerated tendon after partial-thickness and full-thickness tendon harvesting. A total of 30 adult female Sprague-Dawley rats were allocated to 2 groups-15 rats underwent partial-thickness Achilles tendon harvesting (partial-thickness harvesting [PTH] group), and 15 rats underwent full-thickness Achilles tendon harvesting (full-thickness harvesting [FTH] group). The quality of the regenerated tendons was compared 180 days after tendon harvesting.
All 21 patients showed regeneration of the peroneus longus tendon (PLT) (homogeneously dark on both T1- and T2-weighted sequences). The cross-sectional area of the regenerated tendon divided by that of the preoperative tendon was 92.6% and 84.5% at 4 cm and 9 cm proximal to the tip of the distal fibula, respectively. In the animal study, the mean histologic score was better for the PTH group compared with the FTH group (9.17 ± 1.35 vs 14.72 ± 0.74; P < .001). The ultimate strength and the stiffness of the regenerated Achilles tendon were significantly higher for the PTH group compared with the FTH group (35.5 ± 8.3 vs 22.4 ± 8.3 N, P = .004; and 31.6 ± 7.7 vs 23.5 ± 4.8 N/mm, P = .016).
The PLT was found to regenerate after partial-thickness harvesting on MRI. In the animal study, the quality of the regenerated tendon when half of the tendon was preserved during tendon harvesting was better than that after full-thickness tendon harvesting.

OBJECTIVE: To investigate the effectiveness of the reconstruction of posterior cruciate ligament (PCL) with platelet rich plasma (PRP) and 3-strand peroneal longus tendons under arthroscope.
METHODS: Between June 2014 and December 2017, 58 patients with PCL rupture were randomly divided into two groups: the trial group (PRP assisted reconstruction of 3-strand peroneal longus tendons) and the control group (4-strand hamstring tendon reconstruction alone), 29 cases in each group. There was no significant difference in gender, age, injury side, Kellgren-Lawrence grade, time from injury to operation, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, International Knee Documentation Committee (IKDC) score, Lysholm score between the two groups ( P>0.05). Before operation, at 3 months and 12 months after operation, the IKDC score and Lysholm score of the two groups were recorded to evaluate the knee joint function, AOFAS ankle-hindfoot score was used to evaluate ankle function; KT-2000 examination (knee flexion of 90°, 30 lbs) was used to evaluate the difference of bilateral knee joint posterior relaxation at 12 months after operation, and MRI was used to evaluate ligament reconstruction; CT was used to evaluate the bone tunnel expansion of femur and tibia at 3 months and 12 months after operation.
RESULTS: The operation was completed successfully in both groups, there was no complication in the donor tendon area. All the incisions healed by first intention. All the patients were followed up for more than 1 year. The follow-up time of the trial group was 13-17 months, with an average of 15.0 months; that of the control group was 15-20 months, with an average of 15.4 months. At 3 and 12 months after operation, there was no significant difference in AOFAS ankle-hindfoot score when compared with preoperative score and between the two groups ( P>0.05). At 3 and 12 months after operation, the IKDC score and Lysholm score of the two groups were significantly improved, and further improvement was found at 12 months when compared with at 3 months ( P<0.05); the scores in the trial group were significantly better than those of the control group ( P<0.05). At 12 months after operation, the difference of the posterior relaxation of the bilateral knees in the trial group was less than 5 mm in 27 cases, 6-10 mm in 2 cases; in the control group was less than 5 mm in 20 cases, 6-10 mm in 6 cases, and >10 mm in 3 cases; the difference between the two groups was not significant ( Z=0.606, P=0.544). At 12 months after operation, MRI of knee joint showed that all patients had good PCL graft. The MRI score of the trial group was better than that of the control group ( t=2.425, P=0.019). CT examination at 3 and 12 months after operation showed that the bone tunnel expansion of femur and tibia in the trial group were significantly better than those in the control group ( P<0.05).
CONCLUSIONS: PRP combined with 3-stand peroneal longus tendons can significantly improve the function and stability of knee joint, effectively promote graft remodeling, and promote tendon bone healing, reduce the expansion of bone tunnel. The effectiveness is satisfactory.
UNASSIGNED: 探讨关节镜下富血小板血浆（platelet rich plasma，PRP）辅助 3 股腓骨长肌腱重建后交叉韧带（posterior cruciate ligament，PCL）的临床疗效。.
UNASSIGNED: 2014 年 6 月—2017 年 12 月选择符合标准的 58 例 PCL 断裂患者，按随机数字表法，随机分为试验组（应用 PRP 辅助 3 股腓骨长肌腱重建）和对照组（单纯 4 股腘绳肌腱重建），每组 29 例。两组患者性别、年龄、受伤侧别、Kellgren-Lawrence 分级、受伤至手术时间及术前美国矫形足踝协会（AOFAS）踝-后足评分、国际膝关节文献委员会（IKDC）评分、Lysholm 评分等一般资料比较差异均无统计学意义（ P>0.05）。术前和术后 3、12 个月两组采用 IKDC 评分及 Lysholm 评分评估膝关节功能，采用 AOFAS 踝-后足评分评估足踝部功能；术后 12 个月，应用 KT-2000 检查（屈膝 90°，30 磅）评估双侧膝关节后向松弛度差异，行 MRI 检查评估韧带重建情况；术后 3、12 个月行 CT 检查评估股骨及胫骨骨隧道内口的扩大程度。.
UNASSIGNED: 两组手术均顺利完成，供腱区均无并发症发生，手术切口均 Ⅰ 期愈合。患者均获 1 年以上随访，试验组随访时间 13～17 个月，平均 15.0 个月；对照组 15～20 个月，平均 15.4 个月。术后 3、12 个月，两组 AOFAS 踝-后足评分与术前比较，以及两组间比较，差异均无统计学意义（ P>0.05）。术后 3、12 个月，两组患者 IKDC 评分及 Lysholm 评分均较术前显著改善，术后 12 个月较 3 个月时进一步改善（ P<0.05）；试验组均显著优于对照组（ P<0.05）。术后 12 个月试验组双膝后向松弛度差异<5 mm 27 例，6～10 mm 2 例；对照组双膝后向松弛度差异<5 mm 20 例，6～10 mm 6 例，>10 mm 3 例；两组比较差异无统计学意义（ Z=0.606， P=0.544）。术后 12 个月复查膝关节 MRI 提示所有患者 PCL 移植物走行良好，试验组 MRI 评分优于对照组（ t=2.425， P=0.019）。术后 3、12 个月复查 CT 示，试验组股骨及胫骨骨隧道内口扩大程度均优于对照组，差异有统计学意义（ P<0.05）。.
UNASSIGNED: PRP 辅助 3 股腓骨长肌腱重建 PCL 能够显著改善膝关节功能和稳定性，有效促进移植物重塑，并可促进腱-骨愈合，减少骨隧道扩大程度，临床疗效满意。.

OBJECTIVE: To evaluate the normal location of the peroneus longus tendon (PL) in the cuboid groove in various ankle-foot positions by ultrasonography in asymptomatic volunteers.
METHODS: Ultrasonographic assessment of the PL in the cuboid groove was performed in 20 feet of ten healthy volunteers. Each PL was examined in five ankle-foot positions (i.e., neutral, dorsiflexion, plantar-flexion, supination, and pronation). The PL location was qualitatively categorized as \"inside\" when the PL was entirely within the cuboid groove, as \"overlying\" when some part of the PL was perched on the cuboid tuberosity, and as \"outside\" when the PL was entirely on the cuboid tuberosity. For quantitative evaluation of the PL location, the distance between the PL and the cuboid groove was measured. The width of the cuboid groove was measured in the neutral position.
RESULTS: The PL location did not significantly change with changes in the ankle-foot position. Qualitatively, an \"overlying\" PL was the most common type, regardless of the ankle-foot position. \"Inside\" PLs were found in only 35, 20, 30, 25, and 35% of feet in neutral, dorsiflexion, plantar-flexion, supination, and pronation positions, respectively. The quantitative PL location was also not significantly different among all ankle-foot positions and it was significantly negatively correlated with the cuboid groove width.
CONCLUSIONS: In healthy volunteers, 65% or more of the PLs were partially or completely located outside of the cuboid groove, regardless of the ankle-foot position. The PL location relative to the cuboid groove was related to the cuboid groove width.

BACKGROUND: Anatomic coracoclavicular (CC) ligament reconstruction (ACCR) provides good outcomes for Rockwood type III and VI acromioclavicular (AC) joint dislocations. Various grafts have been used, but complications from graft harvesting are not uncommon. This study examined the clinical and radiographic outcomes of patients with AC joint dislocations repaired with the autogenous anterior half of the peroneus longus tendon (AHPLT) to achieve ACCR.
METHODS: Patients with a Rockwood type III to V AC joint dislocation and magnetic resonance imaging of the disruption of the CC ligaments, as well as the AC capsule, were prospectively recruited. Patients received ACCR using an autogenous AHPLT graft and were evaluated clinically and radiographically preoperatively and at 1, 3, 6, and 12 months postoperatively.
RESULTS: A total of 18 patients (mean age, 51 years) were prospectively recruited and received an autogenous AHPLT graft ACCR. Fifteen patients completed clinical and radiographic follow-up examinations at 12 months. The mean Constant score (CS) was 51 preoperatively and 93 at 12 months (P <.005). No significant difference was noted at 12 months between the CS of the injured and contralateral shoulder. The mean American Orthopedic Foot and Ankle Society score at 12 months was 99, and this was not different from the value at any other time point. Loss of reduction occurred in 10 patients (56%), and tunnel widening was observed in 9 (50%), but neither was significantly correlated with functional outcome.
CONCLUSIONS: Autogenous AHPLT appears to be a reliable tendon graft source for CC ligament reconstruction.