Patella Alta: Association with Patellofemoral Alignment and Changes in Contact Area During Weight-Bearing

Ward, Samuel R.; Terk, Michael R.; Powers, Christopher M.
August 2007
Journal of Bone & Joint Surgery, American Volume;Aug2007, Vol. 89-A Issue 8, p1749
Academic Journal
Background: Patella alta is a condition which may predispose individuals to patellofemoral joint dysfunction. We compared patellofemoral joint alignment and contact area in subjects who had patella alta with subjects who had normal patellar position, to determine the effect of high vertical patellar positions on knee extensor mechanics. Methods: Twelve subjects with patella alta and thirteen control subjects participated in the study. Lateral patellar displacement (subluxation), lateral tilt, and patellofemoral joint contact area were quantified from axial magnetic resonance images of the patellofemoral joint acquired at 0°, 20°, 40°, and 60° of knee flexion with the quadriceps contracted. Results: With the knee at 0° of flexion, the subjects with patella alta demonstrated significant differences compared with the control group, with greater lateral displacement (mean [and standard error], 85.4% ± 3.6% and 71.3% ± 3.0%, respectively, of patellar width lateral to the deepest point in the trochlear groove; p = 0.007), greater lateral tilt (mean, 21.6° ± 1.9° and 15.5° ± 1.8°; p = 0.028), and less contact area (157.6 ± 13.7 mm2 and 198.8 ± 14.3 mm2 p = 0.040). Differences in displacement and tilt were not observed at greater knee flexion angles; however, contact area differences were observed at all angles evaluated. When data from both groups were combined, the vertical position of the patella was positively associated with lateral displacement and lateral tilt at 0° of flexion and was negatively associated with contact area at all knee flexion angles. Conclusions: These data indicate that the vertical position of the patella is an important structural variable that is associated with patellofemoral malalignment and reduced contact area in patients with patella alta.


Related Articles

  • High resolution magnetic resonance imaging of the patellar retinaculum: normal anatomy, common injury patterns, and pathologies. Thawait, Shrey; Soldatos, Theodoros; Thawait, Gaurav; Cosgarea, Andrew; Carrino, John; Chhabra, Avneesh // Skeletal Radiology;Feb2012, Vol. 41 Issue 2, p137 

    The medial patellar retinaculum (MPR) and the lateral patellar retinaculum (LPR) are vital structures for the stability of the patella. Failure to identify or treat injury to the patellar retinaculum is associated with recurrent patellar instability and contributes to significant morbidity....

  • Standardisation of the description of patellofemoral motion and comparison between different techniques. Bull, A. M. J.; Katchburian, M. V.; Shih, Y-F.; Amis, A. A. // Knee Surgery, Sports Traumatology, Arthroscopy;May2002, Vol. 10 Issue 3, p184 

    Patellofemoral motion is significant clinically, yet in the literature many different methods and terminologies are used, thus making comparison between studies difficult. We review and explain the different methods used for the description of patellofemoral joint motion, compare these methods...

  • PATELLOFEMORAL JOINT KINEMATICS IN INDIVIDUALS WITH AND WITHOUT PATELLOFEMORAL PAIN SYNDROME. MacIntyre, N. J.; Hill, N. A.; Fellows, R. A.; Ellis, R. E.; Wilson, D. R. // Journal of Bone & Joint Surgery, American Volume;Dec2006, Vol. 88-A Issue 12, p2596 

    Background: Patellofemoral pain syndrome is a prevalent condition in young people. While it is widely believed that abnormal patellar tracking plays a role in the development of patellofemoral pain syndrome, this link has not been established. The purpose of this cross-sectional case-control...

  • Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging. Murshed, Khalil Awadh; Çiçekcibaşi, Aynur Emine; Karabacako&gcaron;lu, Aydin; Şeker, Muzaffer; Ziylan, Taner // Surgical & Radiologic Anatomy;Apr2005, Vol. 27 Issue 2, p108 

    Among the anthropometric factors to be considered, anatomic differences in the distal femur and intercondylar notch have been implicated as a cause of the different rates of anterior cruciate ligament (ACL) rupture between men and women; therefore, in this study our aim was to evaluate a number...

  • Knee trauma: cruciate ligament dysplasia associated with fibular hemimelia (2003:7b). Chelli-Bouaziz, Mouna; Bouaziz, Nebil; Bianchi-Zamorani, Maria Pia; Fritschy, Daniel; Bianchi, Stefano // European Radiology;Oct2003, Vol. 13 Issue 10, p2402 

    this article presents an case report related to knee trauma. The sagittal proton-density MR image was obtained at the midline of the joint as proved by the appearance of the patella. Note the absence of the intercondylar notch and aplasia of both cruciate ligaments. The coronal T2-weighted MR...

  • In vitro measurement of patellar kinematics following reconstruction of the medial patellofemoral ligament. Ostermeier, Sven; Holst, Marc; Bohnsack, Michael; Hurschler, Christof; Stukenborg-Colsman, Christina; Wirth, Carl-Joachim // Knee Surgery, Sports Traumatology, Arthroscopy;Mar2007, Vol. 15 Issue 3, p276 

    This study compares the effects of two different techniques of medial patellofemoral ligament (MPFL) reconstruction, and proximal soft tissue realignment on patellar stabilization against lateral dislocation. Eight human cadaver knee specimens with no radiological pathomorpholgy on a straight...

  • Arthroscopic extraarticular reconstruction of the medial patellofemoral ligament with gracilis tendon autograft - surgical technique. Siebold, Rainer; Borbon, Carlo // Knee Surgery, Sports Traumatology, Arthroscopy;Jul2012, Vol. 20 Issue 7, p1245 

    The standard approach to reconstruct the medial patellofemoral ligament (MPFL) is by mini-open incision at its patellar insertion and femoral origin. At the medial patella rim, the MPFL insertion may be visualized in most cases by dissection during surgery. On the femur, it is more difficult to...

  • patellofemoral.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1719 

    An encyclopedia entry for the medical term "patellofemoral," which concerns the patella and femur, is presented.

  • Relationship Between Varus-Valgus Alignment and Patellar Kinematics in Individuals with Knee Osteoarthritis. McWalter, Emily J.; Cibere, Jolanda; Maclntyre, Norma J.; Nicolaou, Savvas; Schuizer, Michael; Wilson, David R. // Journal of Bone & Joint Surgery, American Volume;Dec2007, Vol. 89-A Issue 12, p2723 

    Background: Abnormal varus-valgus alignment is a risk factor for patellofemoral osteoarthritis, but tibiofemoral alignment alone does not explain compartmental patellofemoral osteoarthritis progression. Other mechanical factors, such as patellar kinematics, probably play a role in the initiation...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics