Patellar Tendon Imbrication for Patella Alta

Patella alta is a significant contributor to patellar instability. Historically, distalizing tibial tubercle osteotomy has been recommended for this problem; however, complications such as nonunion, fracture and hardware irritation are concerning. Additionally, the procedure cannot be performed on skeletally immature patients without violation of the proximal tibial physis. The authors describe a technique of patellar tendon imbrication that does not involve hardware or osteotomy. This technique allows for reliable correction of patella alta and provides patellar stability without the complications associated with osteotomy.