{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:02:54Z","timestamp":1789657374929,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,2,8]],"date-time":"2013-02-08T00:00:00Z","timestamp":1360281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>While there are numerous anatomic contributors to patellar instability, the role of patella alta has been traditionally under\u2010appreciated. The goal of this systematic review is to identify the described techniques for treating patella alta in skeletally mature patients with episodic patellar dislocation (EPD) and review their published results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive literature review was performed to identify published surgical techniques and their results. Tibial tubercle distalization is the primary described treatment for patellar alta in patients with EPD, and five studies reporting results of this procedure were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tibial tubercle distalization was generally successful in normalizing patellar height and preventing recurrent patellar dislocation. Physical examination tests for instability such as patellar apprehension remained positive in 15 to 33 % of patients. Patient\u2010reported outcomes were rarely reported and difficult to interpret given the lack of pre\u2010operative values or comparison groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tibial tubercle distalization is an effective technique for correction of patellar height and preventing recurrent patellar dislocations. More comparative studies are required to evaluate patient\u2010reported outcomes of this technique, the effect of an associated tubercle medialization, and the results of supplementing distalization with procedures such as MPFL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Systematic review of case series, Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2445-8","type":"journal-article","created":{"date-parts":[[2013,2,6]],"date-time":"2013-02-06T23:02:03Z","timestamp":1360191723000},"page":"2545-2550","source":"Crossref","is-referenced-by-count":95,"title":["Treatment of patella alta in patients with episodic patellar dislocation: a systematic review"],"prefix":"10.1002","volume":"22","author":[{"given":"Robert A.","family":"Magnussen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Sports Health and Performance Institute The Ohio State University Columbus OH USA"},{"name":"OSU Sports Medicine The Ohio State University 2050\u00a0Kenny Rd, Suite 3100 43221 Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"De Simone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Policlinico \u201cS. Maria alle Scotte\u201d Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Lustig","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hopital de la Croix\u2010Rousse Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Neyret","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hopital de la Croix\u2010Rousse Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Flanigan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Sports Health and Performance Institute The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e31805752d0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B9.19065"},{"key":"e_1_2_6_4_1","first-page":"317","article-title":"Patella infera. 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