ISAKOS: 2019 Congress in Cancun, Mexico

2019 ISAKOS Biennial Congress ePoster #1401


Patella Tendon Imbrication as a Surgical Management of Patella Alta

Jack T. Andrish, MD, Cleveland, OH UNITED STATES
Ronak M. Patel, MD, Westmont, IL UNITED STATES
Michael Gombosh, MD, Miami, FL UNITED STATES
Joshua Polster, MD, Cleveland, OH UNITED STATES

Cleveland Clinic, Cleveland, OH, UNITED STATES

FDA Status Not Applicable


Patella tendon imbrication is a safe and effective procedure to correct patella alta.



To determine if this patellar tendon imbrication technique normalizes patellar height and if the shortened length is maintained at minimum 2-year-follow-up.
Study Design: Retrospective Case-series, Level of Evidence IV


A total of 54 consecutive patients were identified after a retrospective chart review was performed on patients who underwent patellar imbrication from 2008-2013. All 54 patients met inclusion criteria of (1) having undergone the patellar imbrication procedure by the senior author (JA), (2) have established patella alta as defined by an abnormal Insall-Salvati index on pre-operative radiograph, and (3) having had pre-operative recurrent lateral patellar instability. Pre-operative, 3 weeks post-operative, and minimum 2-year post-operative lateral radiographs were analyzed using Insall-Salvati (IS), Blackburne-Peel (BP), and Caton-Deschamps (CD) indices to determine the amount of shortening that was achieved after the procedure and to what degree that shortening was maintained at minimum 2-year follow-up.


Twenty-seven patients (32 knees) had completed a minimum 2-year follow-up. The average patellar tendon length pre-operatively was 6.1cm (Range, 5-8). At 3 weeks and 2 years the average tendon length was 5.1cm and 5.2cm, respectively. Thus, the average change in patellar tendon length from pre-op to 3 weeks post-op was 0.97cm (SD +- 0.67). IS, BP and CD ratios had minimal change (loss of correction) from 3-week to 2-year follow-up; the delta values were 0.04, -0.03, 0.09, respectively. There were no complications directly related to the technique