Patella baja in anterior cruciate ligament reconstruction of the knee

Twenty-nine consecutive arthroscopic assisted anterior cruciate ligament (ACL) reconstructions of the knee were retrospectively studied to evaluate the incidence of patella baja and the correlation of the finding with patellofemoral pain after the ligament surgery. The central one third of the patellar ligament was used and positioned isometrically. The patellar ligament defect was sutured closed. The incidence of patellar chondromalacia at the time of surgery was 24%. The incidence of medial femoral condyle chondromalacia was 59%. The incidence of symptoms of patellofemoral pain after surgery was 14%. Patella baja occurred in 76% of the ligament reconstructions. Two knees showed unexplained patellar tendon lengthening. There was no statistical difference in the results between the knees with and without baja. Postoperative symptoms of patellofemoral pain correlated best with chondromalacia of the patella or the medial femoral condyle at the time of the surgical procedure. Use of the central one third of the patellar tendon with closure of the defect does lead to baja; however, the presence of this radiographic finding does not correlate with patellofemoral pain.