Entnahme eines „split graft“ des Peroneus longus für die rekonstruktive Bandchirurgie am Kniegelenk

The availability of autologous transplant options can be limited, particularly in revision surgery or in the treatment of multiligament injuries. An alternative that has received little attention in Europe but is very popular in Asia is harvesting of the anterior half of the peroneus longus tendon (split graft). The aim of this article is to describe the removal technique of a peroneus longus split graft. The surgical approach is via an approximately 1–2 cm long skin incision posterior to the fibula just above the lateral malleolus. After splitting the subcutaneous layers and the fascia, the peroneus tendons are located: The peroneus longus tendon lies posterior and lateral to the peroneus brevis tendon. This is circumvented with a clamp and incised centrally along the fibers. The anterior half is reinforced with baseball stitch sutures and then severed distally. The anterior half of the tendon is then separated by a tendon stripper and detached from the peroneus longus muscle. The mean graft length is ca. 29 cm. Previous reports on this transplant in the literature have been positive; however, there have been reports of donor site morbidity in the ankle joint.