Do you have a small knee cap? Are you suffering from weakness in the knee region? You may be suffering from a medical syndrome known as Patella Alta. Read on to know all about Patella Alta definition, its causes, symptoms and treatment.
What is Patella Alta?
Patella Alta is a defective condition of the knee. It is characterized by an abnormal position of the patella. Patella is the “knee cap” or the small flat triangular shaped bone that is normally placed in front of the knee and protects the knee joint. An unnatural position of the Patella makes the knee less stable. It affects leg strength and mobility in sufferers.
Patella Alta is a very rare condition. It is also known by the name “High-riding kneecaps”. It is usually found in tall, thin people.
Picture Source: Scuderi GR
Patella Alta Position
In people suffering from Patella Alta deformity, the knee is positioned unusually higher over the femur. The patellar tendon which connects the shinbone (tibia) and the kneecap is longer than usual.
Patella Alta Symptoms
Patella Alta is characterized by a number of symptoms like
Unstability
In people affected by Patella Alta normal stability in the knees is affected. Such people have problems while walking or running. Due to Patella Alta gait is affected to an extent.
Pain
In some cases, patients also experience pain in the knees. Pain in knee is a prominent Patella Alta sign though all cases of patellar pain are not a symptom of this condition.
Dislocated knee cap
This is the most prominent symptom of the condition. In people with this syndrome, the knee cap is found to slide sideways. The knee is usually bent at an angle of 30 degree or more. A high riding knee can pull the patella (knee cap) out of its groove. Patella Alta dislocation can be very painful.
Patella Alta Causes
Patella Alta disorder can arise due to various factors such as
Defective fetal development
In most sufferers, Patella Alta develops as a congenital defect which means the sufferer may have got it while in fetus.
Sports Injury
The condition often results from a sports injury. During athletic activity, sudden changing of direction can pull the knee cap out of its socket and cause dislocation of the patella.
Loose ligaments
If a person suffers from slackened ligaments, intense athletic activity can cause dislocation of the patella. It can also result in Patella Alta knee pain.
Studded footwear
Choice of shoes also plays a factor behind this syndrome. Studded footwear puts the foot firmly in contact with the ground. Sudden twisting of the knee, as done while changing direction in sports like football, can result in dislocation of the knee cap.
Body type
Body structure also plays a role in this syndrome. People with a tall, thin frame are predisposed to health conditions like Patellofemoral Pain Syndrome and Quadriceps Tendinitis. These diseases are marked by pain, inflammation and discomfort in the knee.
Tendon Rupture
Patients suffering from rupture of tendons in the patellar region are commonly seen to suffer from Patella Alta of the knee.
Quadriceps Tendonitis
People experiencing swelling in the tendons of quadriceps or thigh muscles are also susceptible to this condition. Quadriceps Tendonitis is responsible for Patella Alta swelling in many people.
Patellofemoral Pain Syndrome
People suffering from this disorder suffer from pain arising due to the contact of kneecap with the thigh bone. This is another reason behind the development of Patella Alta.
Patella Alta Diagnosis
The diagnosis of this condition is mainly carried out with the aid of Patella Alta radiograph tests. Lateral Radiograph examination of the knee helps determine the position of patella in relation to the knee joint line. The knee is flexed at an angle of 30 degrees and a Patella Alta measurement is carried out. Two medical procedures, Insall and Salvati Method and Blackburne and Peel method, are used to detect if there is more than 20% variation in patellar position. Over 20% variation is considered abnormal.
Patella Alta Treatment
Treatment is necessary if Patella Alta syndrome causes constant dislocation of the knee cap or pain in the patella. There are both conservative and non-conservative options for Patella Alta medical cure. Non-conservative cure involves surgical processes whereas conservative treatment consists of non-operative process.
Patella Alta Conservative Treatment
Non-surgical treatment involves knee-strengthening exercises and R.I.C.E. In patients of Patella Alta exercises help in making the knee stronger and more stable. This reduces or completely eliminates any difficulties in walking or running. It also reduces pain and discomfort in the patellar region.
R.I.C.E consists of giving rest, applying ice, compressing and elevating the knee cap. A combination of R.I.C.E and knee strengthening exercises is the best way for Patella Alta management. For patients of Patella Alta physical therapy is often necessary.
Patella Alta Non-Conservative Treatment
If the non-surgical methods fail to treat the condition, it becomes necessary to use surgical procedures. The surgical options for knee treatment involve:
Arthroscopy
The knee joint is examined with an arthroscope and a small incision is made to carry out any repairs.
Patellectomy
The patella (knee cap) is removed with the help of a careful surgical operation in this process. A Patella Alta surgery provides permanent relief from patellar pain.
Lateral Release
This surgical process helps loosen the compact lateral tissue-like structures from the patella. Patella Alta lateral release has become quite a controversial process these days.
VMO Advance
Vastus Medialis Oblique advancement adjusts the position of the patella within the groove. It improves movement and knee stability in affected people.
TTT/TTO
This method is used to correct the alignment of the knee cap with relation to the femur. It also helps in making the knee cap more compact to prevent Patella Alta recurrent dislocation.
it is painful and i want to go straight to surgery. at 43 years old i need to be able to work and play sports again with my 2 year old son!!! the veterans admin. wants me to begin with phys. therapy. i know this is not going to fix this!
very informative i’d like to go straight to surgery but have been told by the VA that i have to deal with pys. ther. first.
Good ueseful article for patients with patella alta problem.
my daughter is 27 and was born with what was described to me back than as lax muscles and ligaments,she did not stand up or walk until 3 years old,she is now labeled as intellectually disabled but her brain scan at one yr old indicated nothing wrong,she also has one kidney not fully formed,the doctors at the time said her brain was probably concentrating on her body parts that were not developed and other parts are developing slower such as her learning,now she is presenting with knee issues,she is very tall and slim, i heard that due to her balance and late everything developing if she had delayed learning instead of intellectual and if this new knee issue is patella Alta derived from her original physical problem? thanks any information would be appreciated
Born with this too. Many dislocations of lt knee . Surgery to correct at 32. Right corrected at 48. Living with this I now have arthritis in right knee. 2 surgeries to it ., never developed quad muscles and always falling. Lax muscles through body.. keep exercising. Strained these knees again and I think I will start wearing braces on both knees when I need it. I am no longer able to walk very far without cane or walker. Most doctors don’t believe me.
My son of 13 yrs old diagnosed with patella Alta..he has mild intellectual disability..could not cope with academics in regular stream..now doctor says..surgery is the option..anyone there..who has seen or living without surgery..please ineed help to boost myself..very depressed
Diagnosis of patella alta age 36 told notbing could be done. I feel alone i went for a a secon opinion and the consultant has been a bit more helpful. Trying physio but because knee is so swollen they cant do the physio. At my wits end i have my whole life ahead i cant just accept it and get on with it ome days worse that others.