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- See:
       - Malposition of Joint Line:
       - Patellar Clunk Syndrome:

- Discussion:
    - more frequent than patella alta;
    - data suggest that maintenance of a ht between 10 and 30 mm is optimal
    - this problem may be prevented by keeping resection line of the tibia less than 10 mm;
    - in resecting distal femur for component placement, care must be taken to maintain articular relative to attachments of collateral ligs;
           - most frequent error is allowing a mismatch between the AP depth of the anatomic knee and the prosthesis;
           - therefore, restoration of AP dimensions of the medial femoral condyle with appropriate rotational considerations is critical in 
                   maintaining the prosthetic patella at its ideal position;
    - revision procedures include lateral retinacular release, revision of component & either a V/Y or step cut lengthening of patellar ligament