Focus on Quality

Focus on Quality:
Peroneus Longus and Posterior Tibialis Bio-Implants in Knee Reconstruction

Human tendon allografts have been used in clinical sports medicine applications for more than two decades. In particular, reconstruction of the anterior cruciate ligament (ACL) is one of the most common soft tissue reconstructive procedures in orthopedic practice. Human allograft tissue offers several distinct advantages over autografts including shorter operative times, reduced surgical morbidity, decreased postoperative pain and improved cosmesis. Also, recent advances in terminal sterilization technologies virtually eliminate the risk of disease transmission while maintaining clinically relevant properties.

Allografts for sports medicine applications are recovered from a variety of sites and include the patellar tendon, semitendinosus tendon, tibialis tendon (both anterior and posterior), gracilis tendon, peroneus longus and Achilles tendon. While the anterior tibialis tendon is a widely used and studied allograft for ACL reconstruction, little has been presented regarding the use of the anatomically and structurally similar posterior tibialis and peroneus longus. Now, there is a growing demand for additional grafts such as the posterior tibialis tendon and peroneus longus. For perspective, at LifeNet Health, these grafts have been available for a number of years and, in addition to 14,000 anterior tibialis tendons, over 10,000 posterior tibialis and 1,000 peroneus longus grafts have been distributed from 2006-2009 alone. Positive clinical experience has been gained and biomechanical studies also indicate that these tendons have the requisite strength for successful clinical outcomes.

Recent literature examines the biomechanical properties and clinical uses of posterior tibialis and peroneus longus. The biomechanical studies all demonstrate the sufficient clinical strength of the posterior tibialis and peroneus longus when compared to the anterior tibialis and to clinically relevant benchmarks. Taken together, both the posterior tibialis and peroneus longus grafts are considered appropriate tendons for sports medicine reconstructive procedures.

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