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R.A. Magnussen, C. Mayer, E. Servien, G. Demey, M. Jacobi, S. Lustig, P. Neyret
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Results
Mean follow-up was 9.6 years (range, 6 to
14 years). The mean length of the patellar
tendon changed from 56.3 ± 2.7mm (range,
52.2 to 61.7mm) pre-operatively to 44.3
± 8.6mm (range, 32.2 to 60.9mm) post-
operatively (p<0.0001). Significant changes in
patellar height were also noted between the
pre- and post-operative radiographs (Table 1).
No cases of patellar dislocation occurred post-
operatively. No radiographic evidence of
degenerative change was noted in the patello
femoral or tibiofemoral compartments at
follow-up.
The mean post-operative subjective IKDC
score was 75.6±9.5 (range 55.2 to 98.9).
Fig. 3: Intra-operative photographs of treatment of patella alta and elongation of the patellar tendon with
tibial tubercle distalization and patellar tendon tenodesis. A: Prior to fixation of the tibial tubercle bone
block (TT), two suture anchors (arrows) are placed near the top of the original position of the tibial tubercle.
B: The tibial tubercle (TT) is the fixed in a distalized position. The sutures are visible behind the patellar
tendon (PT). C: The sutures are then passed through the tendon and tied (arrows), tenodesing the patellar
tendon (PT) proximal to the tibial tubercle (TT).
Fig. 4: Pre-operative (A) and post-operative (B)
lateral radiographs demonstrating distalization of
the tibial tubercle and tenodesis of the patellar
tendon. The distances used to calculate the Insall-
Salvati ratio (solid lines) and Caton-Deschamps
index (dashed lines) are shown on both films.
Pre-operative
Post-operative
Significance
Patellar Tendon Length (mm)
56.3 ± 2.7
44.3 ± 8.6
p < 0.0001
Caton-Deschamps Index1
1.22 ± 0.17
0.95 ± 0.22
p < 0.0001
Insall-Salvati Ratio11
1.42 ± 0.17
0.91 ± 0.18
p < 0.0001
Table 1: Changes in Patellar Tendon Length and Patellar Height with Surgery