Patella baja

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja

“…Several factors have been described that cause patella baja such as shrinking of the tendon, fibrosis of the Hoffa fat pad, intra-articular adhesions, or weakness of the extensor apparatus. 3,5,6 Until today, it is not entirely professed why patella baja occurs. In our experience and as also described in several studies, 3,4,6 patella baja is often associated with a pathology of the extensor mechanism such as immobilization due to pain, weakness/paralysis of the quadriceps due to trauma, prolonged tourniquet, or persistent effusion of the knee joint.…”

“…3,5,6 Until today, it is not entirely professed why patella baja occurs. In our experience and as also described in several studies, 3,4,6 patella baja is often associated with a pathology of the extensor mechanism such as immobilization due to pain, weakness/paralysis of the quadriceps due to trauma, prolonged tourniquet, or persistent effusion of the knee joint. Along with the shortening of the tendon, often an increase in tendon thickening is found.…”

“…This can be due to postoperative paralysis of the quadriceps after prolonged tourniquet, persistent knee joint effusion with functional insufficiency, prolonged immobilization, or pain. 3,4 The resultant shortening of the tendon is either due to a pathologic and biological shortening of the fibers or due to a mechanical binding between the tendon and the upper tibia. Reasons can be retraction due to scar tissue, adherences of the proximal end of the tibia, contracture of the Hoffa fat pad or patellar retinacula, chronic quadriceps tear, or paralysis of the quadriceps.…”

“…Patella baja is defined by an Insall-Salvati index <0.8 or a difference of the length >15% compared with contralateral. 3,5 Yet, patella height indices are a constant matter of debate. If conservative Image of a right knee.…”

Anatomy of patellofemoral joint

“…Erken tanınıp tedavi edilirse geri dönüşümlüdür, aksi takdirde bu anormal pozisyonu cerrahi ile düzeltmek gerekir. [8] Patellanın yukarıdaki tabanına kuadriseps femoris kasının vastus intermedius ve rektus femoris başları, yan kenarlarına vastus medialis ve vastus lateralis başları tutunur. Bu başların ortak tendonu patellanın aşağı doğru bakan tepe kısmı olan apex patellada yoğunlaşarak patellar bağı oluşturur ve bu bağ aşağıda tuberositas tibiaya tutunarak sonlanır (Şekil 1).…”