Distal realignment procedures are those surgical procedures performed below the kneecap in an attempt to better align it in the groove of the underlying femur bone.
Page updated October 2023 by Dr Sheila Strover (Clinical Editor)

Procedures vary, depending on whether the patella is moved sideways or forwards or a combination of these.
Patellar instability
Distal realignment may be performed for recurrent patellar instability, such as recurrent subluxation or dislocation.
Peer-reviewed papers
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Citation: Bayoumi T, van Duijvenbode DC, Benner JL, Boerma-Argelo KDS, Stavenuiter MHJ, van der List JP. Clinical Improvement Is Achieved Following Tibial Tubercle Distomedialization for Patellar Maltracking and Patella Alta Without Instability. Arthrosc Sports Med Rehabil. 2021 Jun 15;3(3):e845-e853. doi: 10.1016/j.asmr.2021.01.027. PMID: 34195653; PMCID: PMC8220615.
Quote:
"In this case series study, distomedial TTT led to clinically relevant functional improvement and pain reduction in patients with patellar maltracking and patella alta without instability. However, the ROH [removal of hardware] rate was high (72%)"
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