The patella alta positional fault is the superior displacement of the patella in the femur’s trochlear groove. This condition causes pain and discomfort due to patella articular chondromalacia. It is also six times more common in people with patellar osteoarthritis than in those with normal patellar articular cartilage. A non-traumatic congenital or developmental condition causes patella alta. A person with patellar tendons longer than 52 mm may have it . Patella alta may be caused by genetic and environmental factors.
Image and Indices Diagnostics
Imaging is usually used to diagnose patella alta. Multiple indices measure the patella’s position relative to the femur. This includes:
- This index measures the ratio of the distance between the lower pole of the patella and the tibial plateau (TTP) to the patellar articular surface length. Patella alta is indicated by a CDI above 1.2–1.3.
- ISI: Insall-Salvati Index The ISI is the ratio of patellar tendon (PT) length to patella length. Patella alta is often indicated by an ISI value above 1.2.
- Blackburne-Peel Index (PBI): This index compares patella length (PL) to patellar articular surface length. PBI over 1.0 indicates patella alta.
- Patellotrochlear Index (PTI): The PTI is the ratio of the length of the patellar articular surface to the distance between the deepest point of the trochlear groove and the highest point of the patella. Patella alta is indicated by a PTI below 0.125 to 0.28.
These indices help doctors of Dallas pain clinic diagnose and classify patella alta severity for proper treatment. Understanding patella alta’s definition, causes, diagnostic imaging, and indices is essential to choosing the best treatment. Patella alta treatment, surgical interventions, and recurrent patellar dislocation management will be discussed in the following sections.
Treatments for Patella Alta
Several treatments for patella alta aim to relieve symptoms and improve patella alignment and function. Patella alta treatment depends on severity and individual needs. Physical therapy and exercises, bracing, taping, NSAIDs, weight management, and lifestyle changes are three common treatments.
PT and Exercise
Physical therapy is often the first treatment for mild patella alta. Quadriceps strength, knee joint flexibility and strength, and patellar alignment are its main goals. Physical therapists use manual gliding and taping to change patella resting height, reduce knee pain, and correct alignment.
PT exercises may include:
- Quad sets, leg presses, and squats improve knee muscle balance.
- Stretching the hamstrings and calves improves flexibility and muscle length.
- Improve patellar tracking and stability with stabilization exercises.
- Maintaining joint mobility through a range of motion exercises.
- A qualified physical therapist should guide you through the exercises to ensure safety. Visit our quadriceps tendonitis treatment article for patella alta-specific exercises.
Bracing, Taping, and NSAIDs
Patella alta treatment may include bracing and taping. These interventions support the knee and increase the patellofemoral contact area. Patella alta patients may benefit from taping for symptom management and activity tolerance.bNSAIDs may also be prescribed for patella alta pain and inflammation. NSAIDs reduce pain and make physical therapy and exercise more comfortable. Before using NSAIDs, consult a doctor to determine their suitability and discuss side effects and drug interactions.
Weight and Lifestyle Changes
Weight management helps manage patella alta. Excess weight can put pressure on the knees, worsening symptoms. Losing weight through healthy eating and exercise can reduce knee joint stress and symptoms. For weight loss tips, see our weight management article.
In addition to weight management, lifestyle changes can help patella alta. Avoiding high-impact sports and exercises can reduce knee pain and damage. Strengthening knee muscles with swimming or cycling can improve knee stability and health. To make sure lifestyle changes are right for you, talk to a pain management in Dallas. Physical therapy, exercises, bracing, taping, NSAIDs, weight management, and lifestyle changes can help patella alta patients reduce pain, improve knee function, and improve their quality of life. A healthcare professional should help you create a customized treatment plan.
Incisions for Patella Alta
In severe patella alta, surgery may be needed to stabilize the kneecap. Patella alta is treated with tibial tuberosity osteotomy and patellar tendon grafting. Remember that these surgical interventions should only be considered after non-surgical treatments have failed.
Summary
Patella alta requires a multifaceted diagnosis and treatment. Preventing complications and improving patient outcomes requires early detection and intervention. Whether conservative or surgical, a customized treatment plan yields the best results. Further research on patella alta will improve future management strategies.
