Patella alta. What are some of the causes?

Mal-tracking, lateral release, medial reefing, tibial tuberosity transfer, patellar arthritis, patellectomy, plica, patello-femoral braces. For patellar fractures, see Board on 'Bone Breaks around the knee'.
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hugo
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Patella alta. What are some of the causes?

Post by hugo »

I've been told by a colleague of the OS that did my LR and medial plicature (for lateral subluxations) that my knee caps are high...

Something that I was not aware before the surgery last year.

I've also been told I have some degree of patellar dysplasia, which I was aware of, but most OSs I've seen don't give it that much importance.

In an effort to educate myself, I've read a few articles on platella alta. Some claim that the posistion of the TT could be a factor, pointing to osteotomies as a solution. My OS and his colleague seem to be of the opinion that these do not always work and are not keen on doing any on my knees...

I've read a few articles that focus more on the length of that patellar tendon as cause of high patella, such as this:
http://rad.usuhs.edu/medpix/medpix.html ... ecnum=4833

For what it's worth I think maybe my knee problems are caused by a mixed bag of issues. Tight LR, and to a certain degree high platella and maybe to a lesser degree the patellar dysplassia.


Just wanted to put this out there and see what some of you more insightful guys and gals think about it.
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Re: Patella alta. What are some of the causes?

Post by FormerlyActive »

Its an interesting question. I will have to look at the link you gave, thanks for that.

I don't believe they would do TTT just for high patella, there are typically other conditions. I think the issue with the high patella is the initial tracking is difficult, i.e. 0 to 30 degrees.

I also have patella alta or borderline, in my case it is genetic. They detect it on the Xrays. It often accompanies miserable mal-alignment. Do you have that? Also how long ago was your plica surgery and why did they remove it? I ask because I also had that and it is considered rate only 2-5% of surgeries. My personal theory is patalla maltracking impinges on the plica.

I don't know what the dysplasia is.

Feel free to PM me if you prefer. Best regards
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together
hugo
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Re: Patella alta. What are some of the causes?

Post by hugo »

I had an LR + medial plicature April 2007. You're confusing it with plica removal. I never had that. Medial plicature is when they tighten or advance your medial retinaculum with sutures if I'm not mistaken...

Aren't TTT advised for those where the TT sits in an incorrect position? I don't really know just asking.

Trochlear or patellar dysplasia is when the trochlear groove is not deep enough or the patella is flatter than it's supposed to be. Is something along these lines...
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Re: Platella alta. What are some of the causes?

Post by Leentje »

I have patellar dysplasia and patella alta among other things, and at first my OS wanted to lower my patella by making a Y-shape incision in my tendon above the patella when doing the TTT but he decided not to as it would probably wouldn't do much good. I had the TTT wich did do it's job, although not cure me, but am happily active!

Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation
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Re: Patella alta. What are some of the causes?

Post by subail »

I had patella alta but in my case it was because I suffered a complete rupture of my patellar tendon and required extensive reconstruction...
Dislocation of left patella and as a result left patellar tendon rupture in the medial section/torn at both ends.
3 Previous surgeries-semitendiosis tenodesis
Reconstruction surgery left knee October 10 '07
TKR right knee May 25 '10.....successful!
Limited ROM/TKR left knee May 25 2015...successful.
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Re: Patella alta. What are some of the causes?

Post by Clarinet'09 »

I have patella alta as well. And i have been told it is caused a lot of times by Osgood Schlatters, an overuse injury that created a calcium deposite (lump) underneath the tendon and it stretches it out. It can also be genetic. And yes they do TTTs for Patella alta i am going to be having one sometime in November and i know of other people who had patella alta and had TTTs for it.
If you have any other questions just ask me.
-Chels
Chelsea - 17 years old - soccer + band = LIFE
4/29/06  left knee popped followed by intense pain while playing soccer
5/30/06  Bone spur removal
4/20/07  LR right knee
11/19/07 LR left knee
1/16/08  MUA left knee
11/03/08 LR recon, MPFL recon right knee
4/20/09 LR recon, MPFL recon left knee
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