DOI: 10.16899/jcm.2004478 ISSN: 2667-7180

The Effect of Patellar Height on Load Distribution in the Knee: Is It a Risk Factor for Meniscal Tears?

Cihan Adanaş, Ali Mahir Gündüz, Sezai Özkan, Murat Canlıışık
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Objective: The aim of this study was to determine the frequency of patella alta in patients with arthroscopically confirmed meniscal tears and to evaluate the relationship between patellar height and the side, anatomical location, and type of meniscal tears. Materials and Methods: A total of 152 patients (84 males, 68 females; mean age 36.2 years) who underwent knee arthroscopy were included in this study. Preoperative lateral knee radiographs were evaluated to calculate the Insall-Salvati Index (ISI) and Caton-Deschamps Index (CDI). An ISI > 1.2 was defined as Patella Alta. Meniscal tear side (medial, lateral, bilateral), anatomical zone (anterior horn, body, posterior horn), and tear pattern were documented from arthroscopy reports and correlated with radiological measurements. Results: Arthroscopic evaluation revealed medial meniscal tears in 84.2% (n = 128), lateral meniscal tears in 9.2% (n = 14), and bilateral tears in 6.6% (n = 10) of the patients. The overall prevalence of patella alta was 42.1% (n = 64). Patients with patella alta demonstrated a significantly higher proportion of medial meniscal tears (87.5%) compared to those with normal patellar height (p = 0.042). Anatomical location analysis showed that tears in the patella alta group were predominantly localized in the posterior horn (73.4%, n = 47) compared to the normal patella group (p < 0.001). Furthermore, complex and flap tear patterns were significantly more frequent in the high patella group (p = 0.016). Conclusion: Patella alta is present in a substantial proportion (42.1%) of patients undergoing arthroscopy for meniscal tears. High patellar height exhibits a strong clinical and anatomical association with medial meniscal posterior horn tears and complex tear patterns. Recognizing this biomechanical influence of the extensor mechanism is crucial when planning surgical repair and rehabilitation strategies.

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