Patellar tilt is when the patella is tilted to one side, generally the lateral (outer) side, secondary to tightness in the lateral retinaculum, the fibrous restraint at the lateral side of the patella.
Page updated November 2023 by Dr Sheila Strover (Clinical Editor)
Patellar tilt and instability
Patellar tilt may be static or associated with instability such as patellar subluxation or even dislocation.
Cartilage damage from patellar tilt
Chronic patellar tilt may eventually cause excessive lateral pressure syndrome (ELPS) which may lead to damage of articular cartilage, with changes in both the medial cartilage from pressure alteration and overload on the lateral cartilage which may lead to arthritic damage there and chronic pain.
"A lateral tilt, when the medial border is higher than the lateral border, can lead to lateral patellofemoral compression syndrome...An inferiorly tilted patella can be problematic as it may pinch or irritate the patellar fat pad that lay underneath the patellar tendon..."
Citation: Loudon JK. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT. Int J Sports Phys Ther. 2016 Dec;11(6):820-830. PMID: 27904787; PMCID: PMC5095937..