Patella Alta

Patellar Tendon Rupture X-ray


It is a condition in which the Patella is abnormally high riding with respect to the Femoral Trochlea (groove). This Patella is very mobile and is prone to subluxations and dislocations.

Associated findings:

  • Small Femoral Trochlea
  • Hypoplasia of Vastus Medialis


Congenital Acquired:

  • Patella Tendonitis
  • Patella Tendon Rupture

Clinical Features:

  • Pain
  • Knobly Knee sign: At 90 degree flexion Patella lying high above the Knee and to outer side
  • Recurrent Subluxation.
  • Recurrent Dislocations


  • X-ray: Length of Patella ligament = Diagonal length of Patella

Normal Patella Ligament


High Riding Patella

High Riding Patella

Conservative Management:

  • Rest, ice, anti-inflammatory medications
  • Quadriceps muscle strengthening

Surgical Management may involve any one or all of the following:

  • A “lateral release” of the lateral structures is performed to decrease lateral pull on the Patella. (controversial)
  • Tibial Tubercle (TT) is transferred Medially, Distally and Anteriorly.
  • A “VMO(Vastus Medialis Obliqus) advancement” is performed to move this muscle distally and laterally across the Patella to improve its mechanical efficiency.
  • Chondroplasty Patella (if necessary) to repair any lesions that may be present on the back of the Patella.