Patella alta

High-riding patella (patella alta) subluxing to the outer (lateral) side during knee extension. Because the underlying trochlear groove is flatter at its upper end, it is easier for the patella to subluxate or dislocate when the knee is in extension (straight).

Cause of patella alta

Patients with primary patella alta are generally born that way. It may cause no problem, or they may suffer from anterior knee pain and/or patellar instability. In cases of rupture or avulsion of the patellar tendon, the quads muscle may pull the patella into an abnormally high position.

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Patella alta in the younger patient

Tightening up the patellar tendon with a series of 'imbrication' sutures, in conjunction with MPFL reconstruction offers an alternative for the younger patient.

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Forum discussions

• Patella alta. What are some of the causes?

  Various explanations discussed by patients for why their patella is high.

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Peer-reviewed papers

• Quote:

  "Patella alta is a major contributor to recurrent patellar instability, which is commonly seen in young athletes. Distalizing tibial tubercle osteotomy has been used for the correction of patella alta and patellar instability, but this procedure is contraindicated in the skeletally immature patient population, as it could lead to growth arrest of the proximal tibial physes."

  Citation: Hinkley P, Fletcher C, Strickland S. Patellar Tendon Imbrication for the Treatment of Patella Alta in Skeletally Immature Patients. Arthrosc Tech. 2022 Aug 17;11(9):e1577-e1582. doi: 10.1016/j.eats.2022.05.002. PMID: 36185114; PMCID: PMC9519932.

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