Plantaris Tendon Autograft Can Restore Patellar Stability in Adolescent Medial Patellofemoral Ligament Reconstruction: A Technical Note

Document Type : TECHNICAL NOTE


1 1 Division of Paediatric Orthopaedic Surgery, Children’s Hospital Zagreb, Zagreb, Croatia 2 School of Medicine, University of Zagreb, Zagreb, Croatia

2 2 School of Medicine, University of Zagreb, Zagreb, Croatia 3 Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia

3 Department of Radiology and Ultrasound Diagnostics, Special Hospital for Pulmonary Diseases, Zagreb, Croatia

4 Department of Radiology, University Hospital Centre Zagreb, Zagreb, Croatia

5 Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia



Medial patellofemoral ligament reconstruction is a standard treatment option for patients with patellar 
instability. The main purpose of this study was to determine whether isolated anatomic medial 
patellofemoral ligament reconstruction using double folded, four-strand plantaris tendon autograft restores 
patellar stability in adolescent patients. Plantaris tendon autografts were harvested through proximal 
approach and used in four adolescent patients. A four-strand autograft was prepared in a double-limbed 
configuration and fixed on the patella and the femur with suture anchors and interference screws, 
respectively. The mean Kujala score improved significantly from 44 ± 24 SD (range, 19 to 69) points 
preoperatively to 94 ± 10 SD (range, 78 to 100) points postoperatively (P< 0.001). All patients reported 
excellent subjective outcomes and returned to their pre-injury level of sporting activities. The use of a 
four-strand plantaris tendon autograft in isolated anatomic medial patellofemoral ligament reconstructi on 
can restore patellar stability in adolescents. 
Level of evidence: IV


Main Subjects