What is Patella Alta?
Patella alta is a condition under which patella gets elevated in relation to that of the femur bone, from its normal position.1 Patella alta is also known as ‘High Riding Patella’. It can also be described as unusual development of knee cap above and out of the joint. It is a rare medical ailment which is usually found in the people having thin contour with a tall physique. Generally it results in a weakness as well as mobility problem along with instability to the knees.
Patella which is also known as the knee cap, is a triangular shaped flat bone located in the front portion of the knee joint.2 Patella is the largest seasmoid bone which use to grow within a tendon of quadriceps femoris. The top side of the patella is faced towards the feet of the body whereas; base keeps on facing in the direction of the torso. Anterior as well as posterior surfaces of the patella or the kneecap are connected through the thinner margin, laterally whereas a thick margin gives it a cover medially. Knee cap anterior portion works as connection of tendon along with quadriceps femoris.
Patella gives the necessary flexion to the joints, required for the mobility and other sorts of movements. It is because of articulate cartilage due to which such flexion is obtained. Knee extensions are facilitated by the quadriceps muscles through the patella as its fulcrum. The routine activities of the life like walking, running and jumping as well are possible because of the knee support as patella is responsible for providing necessary strength and stability for doing such activities successfully, without falling.
Causes of Patella Alta
Though there is no exact etiology or cause for the existence of the patella alta but some of the factors can be claimed as reasons for the onset of this particular ailment.
- A Person’s Body Structure can be a cause of patella alta. A person having a tall structure along with a thin built of body are very much prone to this particular ailment.
- Patellofemoral Pain can cause patella alta. It is a type of syndrome which arises due to the contact of a knee cap with thigh bone. Anyone found with this syndrome are at greater risk of this patella alta disorder.
- Injuries of the Knee can cause patella alta. This could be a primary cause for the patella alta medical condition as various strenuous activities like sports can set the kneecap out. All of a sudden change in the direction during the activity could make it happen very often. A pulled out knee cap could result in a dislocation of the patella which further can develop into the high-ride kneecap conditions.
- Knee Twisting might also cause patella alta. Any reason other than the sporty activity, under which frequent change or sudden change of direction is associated, like jerks, could cause this patella Alta condition.
- Congenital Defects can cause patella alta. This defect is acquired during the development of the embryo. Under this condition person having the patella Alta conditions since its birth.
Signs and Symptoms of Patella Alta
There are few signs and symptoms for patella alta, person suffering from the patella alta condition have a dislocated kneecap which is, somehow, got oddly positioned at higher side of the femur bone. This irregularity can create few of the noticeable signs and symptoms, such as:
- Pain in the Patella is the major symptom of patella alta. The patient could complain for the pain in the patella portion, but it is a subject matter of proper diagnosis for patella alta condition as every patella pain could not be claimed as high-ride conditions.
- Chondromalacia Patella is also a symptom of patella alta. This condition, indicating patella alta, is identified by fissures and blisters around the patella cartilage worsen because of the patella misalignments.
- Gait Instability could be a symptom of patella alta. People having instable or irregular gait might have a condition of patella alta as it is primarily responsible for the unsteady gait conditions.
- Dislocated Knee Cap is another major symptom of patella alta. When patella gets bend higher than its normal bending it pulls out the knee cap from its actual grooves and results as a condition of painful dislocation of the knee cap. Any of such condition could be a reason for the patella alta ailment.
Complications in Patella Alta
Instability and patellofemoral arthritis are two major complications in patella alta. Person having a condition of patella Alta are usually at a greater risk of having further disorder of patellar instability. If the dislocation or bending of patella is very high in nature it got engaged around flexion arc. The degree of angle is bent is approximately 20-30 degree. It implies that patella is very less stable during long run.
However, patellar tendor which becomes longer has higher windscreen wiper effect or you can say it performs higher action. It becomes quite unstable due to increase in size of patellar tendor and thus it is moves side by side. There is pressure exerted on kneecap due to elevated riding patella which can give rise to a condition of knee pain, damage in articular cartilage as well as increased wear & tear. Ultimately, patellofemoral arthritis can be faced in many situations as well.
Tests to Diagnose Patella Alta
It is not easy to diagnose patella alta. Clinically it is somewhat difficult to evaluate the correct height as well as position of patella with connection to deeper knee structure just by looking or touching the front portion of the knee. You can choose X-ray diagnosis but clear knee appearance is not possible under this process. Through knee specialist you can get detailed assessment as a specialist can look up to the clear images and can make the report.
A person suffering from patella alta may feel the condition of instability due to high contact pressure which develops on front surface whenever patella sits on height. In order to detect sign of camel back on knee the examiner position him/her exactly at the side of the patient suffering from such disease. A bulging portion just alike camel back is seen in patella patients.
From the view of first hump, high placed patella is represented while infrapatellar bursa is observed from second hump. In normal case patella is being directed toward front area of knee while it appears in upward direction in case of patella alta.
Treatment for Patella Alta
There are two methods for treating patella alta. One is termed as conservative treatment for patella alta while the other one is termed as non-conservative treatment for patella alta. The main motive behind such treatment is restoration of knee strength along with stability also including relief in knee pain.
Ample amount of rest will make it heal earlier while reduction in stress as well as pressure will be more fruitful for patella alta treatment. Pain along with inflammation can be reduced up to much extent by ice application. You can try out different physical therapy (PT) to get strength & stability in knee while suffering from patella alta.
Surgery for Treating Patella Alta
To get back the actual position of knee the process of surgery for patella alta can be carried out. Osteotomy which is advancement of tibial tuberosity is a surgical procedure which is usually applied to correct the deformity in the knee position. Whenever you undergo surgery for patella alta the movement of knee is restricted and at least for six weeks and this can be called as knee splints or sometime knee braces.
In case the patient does not respond to any non-invasive cure then only surgical procedures for patella alta are carried out. Depending upon the severity of the patient condition there are numerous surgical options. Some of these are listed below:
- Arthroscopy for patella alta is used to examine the knee joint as well as through small incision, repairs are being made.
- Patellectomy for patella alta is a process in which knee cap is removed by carrying out a surgical operation. It can proffer permanent relief in pain as well.
- In lateral release surgery for patella alta compact tissues structures are loosened with help of surgical process. At present time you will find some of the controversial process for lateral release.
- In VMO Advance or Vastus Medialis Oblique advancement surgery for patella alta, the patella position is adjusted within groove through VMO advancement method. People suffering from patella alta can feel improvement in knee movement and its stability.
- TTT (Tibial Tubercle Transfer) / TTO (Tibial Tubercle Osteotomy) surgery for patella alta. In order to align the position of knee cap along with femur such method is implemented. To prevent recurrent dislocation as well as to make more compact form of knee cap this method is more used.
Recovery Period/Healing Time for Patella Alta
Treatment mode defines the recovery period healing time in patella alta while doctor’s assessment can also be used to get the approximate healing time in patella alta. You can seek your doctors’ advice for its recurrence as well as the recovery time for patella alta.
Braces for Patella Alta
People suffering from patella alta can also face the situation of patella tracking problem and thus knee braces can be of greater help. Choosing the good medical professionals who can assess knee along with patella braces can be vital. This will help you to remain away from this unbearable pain and deposition of knee for long time.