From the Guidelines
Patella alta is primarily caused by abnormal development or elongation of the patellar tendon, which positions the kneecap (patella) higher than normal relative to the femur, and can be influenced by various factors including congenital conditions, genetic predisposition, trauma, and muscle imbalances. These factors can lead to an abnormal positioning of the patella, resulting in patella alta. According to the study by 1, objective evaluation of physical impairments, including muscle strength and movement patterns, can help identify key factors contributing to patella alta.
The study by 1 also highlights the importance of individualized assessment and treatment planning, taking into account factors such as symptom severity, irritability, and patient engagement. Chronic quadriceps weakness, in particular, can contribute to patella alta by allowing the patella to ride higher than normal, as noted in the study by 1. Additionally, neuromuscular disorders and growth disorders affecting bone and soft tissue development around the knee joint can also contribute to patella alta.
Key factors that can influence the development of patella alta include:
- Congenital conditions, such as abnormal development of the patellar tendon
- Genetic predisposition, including inherited connective tissue disorders
- Trauma to the knee, particularly injuries affecting the patellar tendon
- Muscle imbalances, including chronic quadriceps weakness
- Neuromuscular disorders, such as cerebral palsy or muscular dystrophy
- Growth disorders affecting bone and soft tissue development around the knee joint
It is essential to consider these factors when evaluating and treating patients with patella alta, as they can impact treatment outcomes and quality of life. By prioritizing individualized assessment and treatment planning, clinicians can develop effective strategies to address patella alta and related conditions, ultimately improving patient outcomes and reducing the risk of long-term knee problems.
From the Research
Causes of Patella Alta
The causes of patella alta, also known as high-riding patella, are not explicitly stated in the provided studies. However, the following factors are associated with patella alta:
- Abnormal patellar height in relation to the femur, trochlear groove, or tibia with decreased bony stability 2
- Congenital or acquired condition, with recent literature exploring the etiology of patella alta by investigating patellar height as age increases, but with inconclusive findings 3
- Association with pediatric orthopedic conditions, including patellofemoral instability, anterior knee pain, and cerebral palsy 3
Risk Factors for Patella Alta
Several risk factors are associated with patella alta, including:
- Torsional abnormalities of the femur or the tibia 4
- Trochlea dysplasia 4
- Patella alta itself, which represents an important predisposing factor for patellofemoral instability 2
- Lateral patellar instability, which can be caused by baseline morphologic variability within the patellofemoral articulation and alignment, as well as traumatic injury 5
Measurement and Definition of Patella Alta
Various indices have been developed to measure and define patellar height, including: