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6 Plantar plate repair – a single centre, single procedure case series
  1. M Bernardotto1,
  2. S Hodder2,
  3. R Thomas1,
  4. E Barlow-Kearsley2
  1. 1Dept. of Trauma and Orthopaedics, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
  2. 2Dept. of Podiatry Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London


Aim The plantar plate (PP) is an important structure that maintains stability of the metatarsophalangeal joints1 and is commonly injured in athletes such as sprinters and ballet dancers. However, clinical outcomes following plantar plate repair are limited due to the lack of studies and the heterogeneity of surgical procedures.2 This retrospective case series reviews the pre- and post-operative outcomes of a single-procedure PP repair series.

Methods Patients who underwent PP repair using the Arthrex Complete Plantar Plate Repair System (CPR™) were identified in a single academic hospital centre. Pre- and post-operative outcomes were compared using clinical notes, radiological evaluation and the national podiatry surgery clinical outcomes database (PASCOM-10). Parameters measured included PP rupture grading, congruence, alignment, joint stability and Manchester-Oxford Foot Questionnaire (MOXFQ) scores.

Results A total of 20 patients with confirmed PP rupture underwent CPR™ procedure with a team comprising 4 surgeons. Post-operative congruence correction was achieved in 95% of patients, whereas average alignment score (range 0–4) improved from 2.7 to 0.5 and joint stability score (range 0–4) from 2.6 to 0.25. MOXFQ functional outcome scores were available for 65% of patients, showing a 42%, 53% and 42% improvement for weightbearing (W/S), pain and social interaction (SI) domains respectively.

Conclusions This is the first single-centre, single procedure PP repair case series. Objective radiological and clinical measures showed good improvement in the majority of patients. Functional outcome scores were more heterogeneous and limited by incomplete data collection. Our results appear replicable with no difference between surgeons performing the same procedure.


  1. Nery C, Coughlin M, Baumfeld D, Raduan F, Mann TS, Catena F. How to classify plantar plate injuries: parameters from history and physical examination. Rev Bras Ortop 2015; 50(6):720–728.

  2. Elmajee M, Shen Z, A’Court J, Pillai A. A Systematic Review of Plantar Plate Repair in the Management of Lesser Metatarsophalangeal Joint Instability. The Journal of Foot & Ankle Surgery 2017; 56(6):1244–1248.

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