Role of Rotational Osteotomy in the Treatment of Patellofemoral Dysfunction

The most important function of the patella is to improve quadriceps efficiency by increasing the lever arm of the extensor mechanism. It centralizes the divergent forces from the four heads of the quadriceps and transmits tension around the femur to the patellar tendon and the tibial tuberosity. These forces must be as frictionless as possible and equally distributed in the patellofemoral joint. The skeleton dictates where the load will cross the patellofemoral joint, and any variation from optimal skeleton alignment may result in abnormal forces.