Patellar Tendon Imbrication With a Double-Row Configuration for the Treatment of Patella Alta in Skeletally Immature Patients

Patella alta is a major anatomical risk factor for patellar instability. Although a tibial tubercle osteotomy with distalization has been described in this context, a patellar tendon imbrication more directly addresses the pathoanatomy and avoids the risk of physeal and apophyseal injury in skeletally immature patients. This technical note describes a transection-free patellar tendon imbrication technique using a double-row configuration that allows for predictable correction of patella alta, avoidance of risks associated with osteotomy, and the ability to medialize the patellar tendon, optimizing extensor mechanism alignment.