Summary

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

Abstract

Purpose

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

Methods

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.

Results

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