Tibial Tubercle Distalisation and Accelerated Rehabilitation

Inclusion Criteria: * Symptomatic patella alta with recurrent dislocation or subluxation. Long-lasting anterior knee pain not responding to rehabilitation. Exclusion Criteria: Radiographic: * Open growth plates * Iwano \[8\] grade III and IV changes in patellofemoral joint * Caton-Deschamps \<1.1 in MRI * PTI \>50% in MRI * High grade trochlear dysplasia General: * Refuses to participate in the study * Aged less than 15 or more than 35 years * Severe neurological, pulmonal or cardiovascular comorbidities that are contraindications for surgery * Lack of adequate co-operation * Does not adequately understand written and spoken instructions in the local language Those patients who decline to take part in the trial will be asked to join a follow-up cohort as a background population. The patients in this follow-up cohort will be treated "as normal" without allocation, but the follow-up questionnaires will be the same as those given to the randomly assigned population. The patients in the follow-up cohort will also be asked to provide informed written consent.