Table 3.

Advantages and Disadvantages

Advantages

Avoidance of bony patellar complications

No violation of chondral surface

Anatomically truer reconstruction

Cost savings because of hardware-free patellar graft attachment

Sparing of gracilis and semitendinosus tendons for reconstruction of any future ligamentous injuries

Disadvantages

Meticulous dissection of the quadriceps tendon is necessary.

Intraoperative fluoroscopy is required.

In patients with severe trochlear dysplasia, secondary trochleoplasty after closure of the growth plate may be necessary.

Weakening of the graft at the patellar insertion is possible.

Overtensioning of the graft can occur.

Injury to the distal femoral physis with subsequent growth disturbance is possible.