Combined hamstrings and peroneus longus tendon for undersized graft in anterior cruciate ligament reconstruction: A report of two adolescence female patients

Introduction: Anterior cruciate ligament (ACL) rupture is a common injury in young and active population and reconstruction is the mainstay treatment to maintain stability of the knee. Hamstring tendon (HT) is the most popular graft for ACL reconstruction. In certain patient, particularly in women, the size of tendon graft to reconstruct the ACL is unpredictable. In the case of unqualified donor, we need a combined graft from another source to match the size requirement. Case presentation: We present two cases of ACL reconstruction using combination of HT and PLT graft in adolescent female. We evaluate knee functional score and ankle donor site morbidity. In the second case we also did second look for the ACL graft integrity arthroscopically. This study has been reported in line with the Surgical Case Report (SCARE) criteria. Discussion: One year after surgery, International Knee Documentation Committee (IKDC) score for both cases were improved and no ankle-donor site morbidity with good motoric power and 100% American Orthopedic Foot Ankle Score (AOFAS). Conclusion: Additional peroneus longus tendon can be considered as an alternative in undersized hamstring tendon graft without significant donor site morbidity.