What is Patella Baja?
Patella Baja which is also known as patella infera is a condition with exceptionally low lying patella bone or kneecap bone, which is combined with restricted or decreased ROM (range of motion), retropatellar pain and crepitation’s.1
Causes of Patella Baja
Below mentioned are the causes of patella baja:
- Complete knee arthroplasty can be a possible cause of patella baja.2
- Scarring and shortening of patella baja at the posterior.
- If the patella tendons at the anterior of tibia are scarred can reason to patella baja.
- Elevation of the patella joint line, which is known as pseudo-patella baja.
- Over-resection of tibia can cause patella baja.
- Fracture can be a cause of patella baja.
- Any trauma on the bones or ligaments of the knee can cause patella baja.
Signs and Symptoms of Patella Baja
Some of the common signs and symptoms of patella baja include:
- The major symptom of patella baja is that your range of motion is decreased.
- Another symptom of patella baja is that the lever arm becomes decreased.
- Extensor lag is seen in patella baja.3
- The patella interferes against the tibial plate.
- You experience pain on the anterior of your knee.
- A symptom of patella baja is that you use a lot of energy to make movements.
- The quadriceps or patella tendons rupture.
Risk Factors for Patella Baja
The following are the factors of risk for patella baja:
- Dislocation is a possible risk factor for patella baja.
- Knock-knees, fractures, accidents and poliomyelitis are possible risk factors for patella baja.
Complications in Patella Baja
Some of the complications resulting from patella Baja include; the knee becoming very painful, sometimes the knee is very hot, and your range of motion (ROM) is eventually reduced. The patella is likely to become very tight, giving you very poor flexion and extension. You are also in the risk of gaining weight, which in return causes your patella to sublux and lock up. Your movement is restricted, and it becomes very difficult to move upstairs or in raised grounds, since the knee is very painful. In a worse condition, your legs might heal in mal-union, where your bones heal while mal-aligned. This causes additional pain to your knee and a rotational torque in the knee as you walk. As the nailing takes place, you are likely to have scar tissues.
Tests to Diagnose Patella Baja
Doctors can test patella baja using five different methods, which include:
- Blumensaat’s line.
- Insall salvati ratio; it is the ratio of the relative patella height and patellar tendon length. Lateral radiographs and sagittal cross section imaging are used to assess it.
- Modified Insall-Salvati ratio.
- Blackburne-Peel; it is the ratio of upright range, existing amid tibial plateau, patella articular surface & its length.
Treatment for Patella Baja
Before treatment for patella baja, you are examined using X-rays, MRI scan and physical examination.4 Patella baja treatment involves either tibialtuberosity osteotomy, reimplantation proximally, and lengthening of the patellar tendon. In tibialtuberosity osteotomy, a section of the tibia in which the patella tendon is attached gets cut. The bone is deeply cut and placed in a special angle. The bone with tendons attached is proximally brought up. The patella then comes anteriorly, as the angle of the bone cut allows.
Surgery for Treating Patella Baja
If your condition of patella baja demands for surgery, you are taken in an examination room and put into sleep. The main reason for you being put into sleep is to allow for straightening the leg fully, in order to put it into a splint. Closed reduction surgery is then carried on the following day; the surgeon manipulates your fracture into the right position, before putting your leg into a long leg cast. You are then supposed to stay with the cast for some weeks, until the bones stay aligned. However, weekly X-rays are performed to check if the bones are coming apart. After duration of about three and a half weeks, you can be requested to go back for patella baja surgery if your condition is worse. A tibial nail, which is also known as intramedullary rod, is inserted down the tibia, in order to hold the bones in the right position as healing takes place. The nailing procedure usually involves cutting through the knee and the patella tendon. The rod splits the tendon down the tibia. You are then immobilized with plaster for a few weeks.
Coping with Patella Baja
Coping with patella baja is challenging. You should avoid straining your knee after medical surgery for patella baja. Also, you should avoid taking long walks while at still at plaster. However, it is advisable to perform some exercises for patella baja, under trained personnel or as per instructions from your doctor. If on medication, ensure you follow the prescription given by your doctor. Avoid strenuous exercises and always consult your doctor in case of any pain or problems. You should take enough rest and avoid difficult tasks while you are coping with patella baja.
Recovery Period/Healing Time for Patella Baja
The recovery period/healing time for patella baja varies depending on the level of injury, and the capacity of your body to heal. However, it is only your doctor who can give you the right recovery period, depending on the condition and how well the healing is taking place. You should consult your doctor for further questions and information regarding your recovery period.
Braces for Patella Baja
The Patella Baja brace has a U –shaped buttress which is removable. The patella baja brace is designed in such a way that it provides good support and stability to the kneecap. The knee brace is however designed with an inferior U-shaped buttress, which cups the patella, giving the necessary stability for patella baja recovery. The knee brace is unique in such a way that you can freely optimize the placemen according to your needs, since the buttress is removable. The brace has a solid tubular buttress, which ensures the buttress is in good contact with the knee. It also features some stays, which controls it from rolling or bunching during the day. The material used in making the knee brace is cooltex, which is a neoprene alternative and free of latex. The material is hypoallergenic and totally breathable, in order to suit your convenience. The brace can also be used with other knee conditions.
Prognosis/Outlook for Patella Baja
The prognosis for patella baja is decent but if your patella baja is post traumatic, it is rarely asymptomatic. Therefore, you should go for early patella baja surgical rectification, since conservative measures for patella baja have a low chance of success.
Prevention of Patella Baja
The easiest way of preventing problems from occurring during total knee anthroplasty for patella baja is prevention. Although the problem is likely to occur during total knee revision, you can use some preventive measures to control. These include; you should seek medical help in case you experience any knee pain or dislocation. It is advisable to avoid strenuous exercises when you have patella baja, which are likely to cause injury to your tissues and ligaments. Always avoid walking on slippery floors and use protective gadgets while riding.