title: Treatment of patella baja by a modified Z-plasty.
abstract: The purpose of this study was to evaluate the efficiency of a modified Z-plasty for patellar tendon lengthening for the treatment of patella baja. Rather than adapting only two tendon reins according to the conventional Z-plasty method, the modified Z-plasty provides four reins to enable multifold overlapping of the tendon tissue.
  
  
  
  Between 2010 and 2012, a modified Z-plasty procedure was performed in four patients suffering from patella baja. Physical examinations and standardized scoring instruments served as the evaluation measures.
  
  
  
  The median preoperative CD ratio of 0.53 (range 0.43-0.62) was corrected to 1.03 (range 1-1.06) after a median follow-up of 34 months (range 23-41 months). The median preoperative flexion of 108° (range 80-135°) improved to 143° (range 110-145°) compared with the flexion of 145° (range 140-145°) of the unaffected knee. No patients showed any signs of extension lag. The median Lysholm score improved from 49 (range 22-80) to 91 (range 67-95), and the Tegner activity level improved from 2 (range 0-6) to 6 (range 2-6). The median VAS status for pain decreased from an average of 8.5 (range 4-10) to 1 (range 0-2). No complications were observed.
  
  
  
  The modified Z-plasty procedure is a valuable technique for the treatment of patella baja, especially if allografts are not available. This procedure allowed for early mobilization and achieved excellent clinical results.
  
  
  
  IV.
authors: Sportsclinic Austria, Innsbruck, Olympiastraße 39, 6020, Innsbruck, Austria.|Department of Traumatology and Sports Injuries, Paracelsus Medical University, Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
authors: Wierer
authors: W
authors: Guido
authors: Sportsclinic Austria, Innsbruck, Olympiastraße 39, 6020, Innsbruck, Austria.
authors: Hoser
authors: H
authors: Christian
authors: Sportsclinic Austria, Innsbruck, Olympiastraße 39, 6020, Innsbruck, Austria.|Department of Orthopaedic Sports Medicine, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
authors: Herbst
authors: H
authors: Elmar
authors: Sportsclinic Austria, Innsbruck, Olympiastraße 39, 6020, Innsbruck, Austria.
authors: Abermann
authors: A
authors: Elisabeth
authors: Sportsclinic Austria, Innsbruck, Olympiastraße 39, 6020, Innsbruck, Austria. christian.fink@sportsclinicaustria.com.
authors: Fink
authors: F
authors: Christian
mesh_terms: D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000473:pathology* / Q000601:surgery*; D017847:Patellar Ligament / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: Infrapatellar contracture syndrome; Patella baja; Patella infera; Patellar tendon lengthening; Z-plasty