Patella Alta occurs when the kneecap (patella) is positioned too high in relation to the femoral trochlear groove. This condition can lead to:

• Frequent patellar dislocations (luxation)

• Abnormal weight distribution on the knee joint

• Increased risk of cranial cruciate ligament (CCL) rupture

• Progressive arthritis due to chronic joint instability

Causes of Patella Alta

• Congenital malformation – Some breeds, such as Greyhounds, Poodles, and Chihuahuas, have a genetic predisposition.

• Developmental abnormalities – Improper bone growth in puppies can result in an elongated patellar tendon.

• Post-Trauma Effects – Injury to the patellar tendon or femur may lead to an acquired high-riding patella.

Clinical Signs: Does Your Dog Have Patella Alta?

The symptoms of Patella Alta can vary depending on severity, but common signs include:

• Intermittent or persistent lameness in one or both hind limbs

• Knee instability or kneecap visibly shifting out of place

• “Skipping” gait – dogs may occasionally hold the affected leg up when walking

• Difficulty rising or jumping

• Clicking or popping sounds from the knee joint

• Muscle atrophy due to reduced leg use

If left untreated, Patella Alta can lead to arthritis and an increased risk of ACL (CCL) rupture.

Surgical Correction of Patella Alta

Surgical intervention is typically required for moderate to severe cases where lameness, pain, or knee instability is present. The primary goal of Patella Alta surgery is to realign the patella within the trochlear groove and restore normal knee function.

Surgical Techniques for Patella Alta Repair

1. Tibial Tuberosity Transposition (TTT)

• The tibial tuberosity, where the patellar tendon attaches, is surgically repositioned to correct patellar alignment.

• A small bone fragment is cut, shifted, and secured with pins or screws to lower the kneecap’s resting position.

2. Patellar Tendon Shortening

• In cases where the patellar tendon is excessively long, a tendon shortening procedure may be performed to bring the patella into a normal position.

3. Trochleoplasty (Groove Deepening Surgery)

• If the trochlear groove is shallow, it is surgically reshaped and deepened to better hold the patella in place.

4. Medial or Lateral Soft Tissue Adjustments

• Soft tissue tightening procedures reinforce the correct positioning of the kneecap.

• Release techniques may be performed if excessive tension is pulling the patella out of alignment.

5. Corrective Osteotomy for Severe Cases

• Dogs with significant femoral or tibial deformities may require a femoral osteotomy to realign the knee joint entirely.

Post-Operative Recovery & Rehabilitation

Successful recovery from Patella Alta surgery requires strict post-operative management to promote proper healing and prevent complications.

Phase 1: Acute Healing (0-2 Weeks)

• Activity restriction: crate rest or controlled confinement

• Cold compression therapy to minimize swelling and inflammation

• Multimodal pain management, including NSAIDs, opioids, and adjunctive therapies

Phase 2: Gradual Weight Bearing (2-6 Weeks)

• Controlled leash walking to encourage appropriate weight distribution

• Passive range-of-motion (PROM) exercises to prevent stiffness

• No high-impact activity, jumping, or excessive flexion/extension

Phase 3: Strengthening & Rehabilitation (6-12 Weeks)

• Structured physical therapy, including

  hydrotherapy, laser therapy, and targeted muscle strengthening

• Gradual return to normal function with increased activity levels

• Final orthopedic assessment and radiographic follow-up at 8-12 weeks

Long-term prognosis is favorable in cases where early intervention prevents secondary joint degeneration, with most dogs achieving full return to function within 12-16 weeks post-surgery.

Potential Complications & Considerations

While Patella Alta surgery has a high success rate, potential post-operative complications include:

• Patellar tendon inflammation (tendonitis)

  Managed with physical therapy and controlled rehabilitation

• Implant migration or failure: Rare but possible with excessive post-operative activity

• Delayed bone healing: More common in older dogs or those with metabolic bone disorders

• Fibrosis or restricted range of motion: Prevented through structured rehabilitation programs

Surgical success depends on preoperative planning, precise execution, and post-operative management, ensuring optimal long-term function.