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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2014

01-10-2014 | Knee

Treatment of patella alta in patients with episodic patellar dislocation: a systematic review

Authors: Robert A. Magnussen, Vito De Simone, Sebastien Lustig, Philippe Neyret, David C. Flanigan

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2014

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Abstract

Purpose

While there are numerous anatomic contributors to patellar instability, the role of patella alta has been traditionally under-appreciated. The goal of this systematic review is to identify the described techniques for treating patella alta in skeletally mature patients with episodic patellar dislocation (EPD) and review their published results.

Methods

A comprehensive literature review was performed to identify published surgical techniques and their results. Tibial tubercle distalization is the primary described treatment for patellar alta in patients with EPD, and five studies reporting results of this procedure were reviewed.

Results

Tibial tubercle distalization was generally successful in normalizing patellar height and preventing recurrent patellar dislocation. Physical examination tests for instability such as patellar apprehension remained positive in 15 to 33 % of patients. Patient-reported outcomes were rarely reported and difficult to interpret given the lack of pre-operative values or comparison groups.

Conclusion

Tibial tubercle distalization is an effective technique for correction of patellar height and preventing recurrent patellar dislocations. More comparative studies are required to evaluate patient-reported outcomes of this technique, the effect of an associated tubercle medialization, and the results of supplementing distalization with procedures such as MPFL reconstruction.

Level of evidence

Systematic review of case series, Level IV.
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Metadata
Title
Treatment of patella alta in patients with episodic patellar dislocation: a systematic review
Authors
Robert A. Magnussen
Vito De Simone
Sebastien Lustig
Philippe Neyret
David C. Flanigan
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2445-8

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