Abstract
The management of patellofemoral instability is based on a thorough evaluation of
predisposing anatomical factors. Patella alta is one of the utmost causes of objective
instability. The resulting biomechanical changes can lead to recurrent patellar instability,
pain, and focal degenerative alterations. Physical examination is paramount in the
decision-making process. Imaging evaluation has evolved from X-ray-based methods to
magnetic resonance imaging measurements, which enable a more accurate assessment of
the patellotrochlear relationship. Treatment is based on selective correction of the
risk factors, while tibial tubercle distalization osteotomy as well as medial patellofemoral
ligament reconstruction are tools that must be rationally considered. The present
article reviews the surgical rationale for the treatment of patella alta in patellofemoral
instability.
Keywords
patellar height - patellofemoral instability - tibial tubercle distalization osteotomy
- tibial tubercle osteotomy - patella alta - distal realignment
