Peyton’s Tibial Tubercle Osteotomy

Peyton's Tibial Tubercle Osteotomy

Quick Summary

Peyton was a lifelong dancer born with patella alta — kneecaps that sat too high, transferring stress through her patellar tendon and fat pad instead of the joint. Physical therapy could not resolve it. Dr. Sabrina Strickland performed a tibial tubercle osteotomy with distalization, moving the kneecap downward to offload the tendon. Peyton returned to dance pain-free.

People frequently comment on my videos about how helpful it is to see someone else’s story. This is the story of Peyton, who was a dancer from age four on. Her injury was fairly unusual – she was born with her knee caps too high, so the stress was going through the top of her patellar tendon and her fat pad instead of through her knee cap.

This meant we really had to do an operation to fix it – it wouldn’t heal on its own or with physical therapy. So we did a tibial tubercle osteotomy and I distalized it, moving her kneecap down to take the stress off her patellar tendon and fat pad. She’s done amazingly well, which is really important – but it’s also important for others to see that they don’t have to be in pain and they can get back to doing what they love. For more on the underlying condition, see our overview of patellar instability and the related joint preservation osteotomy service.

Watch Peyton’s story. You can also read Peyton’s full success story with photos and recovery details.

Frequently Asked Questions

What is patella alta?

Patella alta is a condition where the kneecap sits higher than normal on the thigh bone. In Peyton's case, this anatomical pattern was present from birth and meant the stress of dancing was carried through the upper kneecap tendon and fat pad, rather than spread through the joint. Front-of-knee pain that persists despite physical therapy is a common consequence.

Why didn't physical therapy resolve Peyton's pain?

Physical therapy can strengthen the muscles around the kneecap, but it cannot change the underlying bony anatomy. Because Peyton's pain came from the kneecap sitting too high — a structural problem — strengthening alone could not redirect the load away from the kneecap tendon. In situations like this, surgically correcting the position of the bony bump on the front of the shinbone (the tibial tubercle) is the only way to durably take pressure off the tendon.

What does a tibial tubercle osteotomy with distalization do?

The tibial tubercle is the bony bump on the front of the shinbone where the kneecap tendon attaches. In a distalization, the bump is detached, moved downward, and re-fixed with screws. That brings the kneecap into a more normal height, which redistributes the load away from the upper kneecap tendon and the fat pad and into the joint surfaces designed to handle it.

Related Reading

Considering treatment for a knee or shoulder concern?

Dr. Sabrina Strickland sees patients at Hospital for Special Surgery in New York City. If you would like a personalized evaluation of your symptoms and options, request a consultation below.

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Medical Disclaimer. This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult with a qualified physician regarding any questions about your orthopedic health. Individual results may vary based on diagnosis, anatomy, and overall health.
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